INSPECTION AND TEST PLAN

EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

A. Preparation
1 ITP Approval
- Request Letter - Database - List of platforms - ITP approved by Migas P -
- List of Platforms - Previous inspection status P R
- Inspection Schedule - Inspection Report P R
- Previous Inspection Summary Report - PerMen ESDM No. 32 Tahun 2021 - P&R

2 Inspection Program Development

- As-built Drawings - As-built Drawings - Inspection Program - API RP-2A P R
- Previous Inspection Summary Report - Inspection Report - Drawing and previous report P R
- Latest Design Appraisal - Design Appraisal available P R
- PerMen ESDM No. 32 Tahun 2021 - Latest Design Appraisal
available

3 Risk Based Inspection

- RBI Status - Inspection Report - Inspection Program - API RP-2A P R
* List Doc No RBI is Attached - Design Appraisal - Drawing and previous report
- Approved RBI Metodology available
(No.1632/18.03/DMT/2016) - API RP-2 SIM
- Availability RBI Document

4 Procedures Review
- CP Procedures - Inspection Program - Personnel Certificates - API RP-2A P R
- NDT Procedures - Company's CP Drop Cell Procedures - Procedure and qualification P R
- Personnel Qualification - Company's NDT Procedures available P R
- Diving Procedures - Company's Diving Procedures - API RP-2 SIM
- PerMen ESDM No. 32 Tahun 2021

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 INSPECTION AND TEST PLAN
EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

B. Above Water Inspection (Level I Inspection)

1 Visual Inspection Deck Structure
- Equipment Lay-out Verification - As-built Drawings - Inspection Record - API RP-2A R A
- Primary Structure - Equipment Database - No modification / layout R A
- Crane Pedestal Column and Boom-rest - Inspection Program change R A
- Emergency escape route - PerMen ESDM No. 32 Tahun 2021 - No significant damage R A
- Safety Device - API RP-2 SIM

2 Visual Inspection Jacket Structure

- Jacket Legs - As-built Drawings - Inspection Record - API RP-2A R A
- Bracings - Inspection Program - No significant damage R A
- Jacket Pile Connection (Crown) - PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM R A

3 Visual Insp. Boatlanding & Barge Bumper

- General Condition (corrosion) - As-built Drawings - Inspection Record - API RP-2A R A
- Rubber Fender - Inspection Program - No significant damage R A
- Barge Bumper - PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM R A

4 Visual Inspection Riser

- Number, Size and Lay-out Verification - As-built Drawings - Inspection Record - API RP-2A R A
- General Condition - Inspection Program - No significant damage R A
- Supports/Clamps/Bolts - PerMen ESDM No. 32 Tahun 2021 - No missing bolt R A
- API RP-2 SIM

5 Visual Inspection Caisson & Conductor

- Number, Size and Lay-out Verification - As-built Drawings - Inspection Record - API RP-2A R A
- General Condition - Inspection Program - No significant damage R A
- Supports/Clamps/Bolts - PerMen ESDM No. 32 Tahun 2021 - No missing bolt R A
- API RP-2 SIM

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 INSPECTION AND TEST PLAN
EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

6 Deck Elevation Survey

- Measurement between cellar deck bottom of steel to - As-built Drawings - Inspection Record - API RP-2A R A
mean sea level - Inspection Program - No significant damage R A
- PerMen ESDM No. 32 Tahun 2021 - No missing bolt R A
- API RP-2 SIM

7 Debris Survey
- Attached debris to bracing on splash zone - Inspection Program - Inspection Record - API RP-2A R A
- PerMen ESDM No. 32 Tahun 2021
- No metallic debris attached to
structure at splash zone area (MSL)

- API RP-2 SIM

8 Cathodic Protection Survey (Drop Cell)

- CP Reading on all leg by drop cell - As-built Drawings - Inspection Record - API RP-2A P W/AR
- Inspection Program - NACE RP0176-2003
- PerMen ESDM No. 32 Tahun 2021 - Minimum voltage -800 mV
- API RP-2 SIM

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 INSPECTION AND TEST PLAN
EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

C Under Water Inspection (Level II Inspection)

1 General Visual Inspection
- Jacket Legs - As-built Drawings - Inspection Record - API RP-2A P W
- Bracings - Inspection Program - No significant damage P W
- Risers, conductors, caissons - Diving Procedures - API RP-2 SIM P W
- PerMen ESDM No. 32 Tahun 2021

2 Cathodic Protection
- CP Reading on all legs - As-built Drawings - Inspection Record - API RP-2A P W/AR
- Inspection Program - NACE RP0176-2003
- Diving Procedures - Minimum voltage -800 mV
- PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM

3 Marine Growth Survey

- Marine growth measurement - As-built Drawings - Inspection Record - Design Appraisal Report / P W
- Inspection Program Latest Requal Report
- Diving Procedures - RBI document
- PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM

4 Anode Survey
- Anode Mapping - As-built Drawings - Inspection Record - API RP-2A P W
- Depletion Observation - Inspection Program - Depletion didn't affect to P W
- Diving Procedures minimum voltage
- PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM

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 INSPECTION AND TEST PLAN
EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

5 Debris Survey
- Attached debris to bracing - As-built Drawings - Inspection Record - API RP-2A P W
- Debris on seabed - Inspection Program - No metallic debris attached on P W
- Diving Procedures structure from MSL to
- PerMen ESDM No. 32 Tahun 2021 seabed
- API RP-2 SIM

6 Scour Survey
- Scour survey on all legs and horizontal member - As-built Drawings - Inspection Record - API RP-2A P W
- Inspection Program - Design Appraisal Report /
- Diving Procedures Latest Requal Report
- PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM

7 Riser Survey
- General Condition - As-built Drawings - Inspection Record - API RP-2A P W
- Supports/Clamp/Bolts - Inspection Program - As built drawing P W
- Suspension from J bow to 20 ft away - Diving Procedures - No significant damage P W
- PerMen ESDM No. 32 Tahun 2021 - No missing bolt
- No hanging riser
- API RP-2 SIM

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 INSPECTION AND TEST PLAN
EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

8 Outboard Conductor Survey

- General Condition - As-built Drawings - Inspection Record - API RP-2A P W
- Supports/Clamp/Bolts - Inspection Program - No significant damage P W
- Diving Procedures - No missing bolt
- PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM

9 Caisson Survey
- General Condition - As-built Drawings - Inspection Record - API RP-2A P W
- Supports/Clamp/Bolts - Inspection Program - No significant damage P W
- Diving Procedures - No missing bolt
- PerMen ESDM No. 32 Tahun 2021 - API RP-2 SIM

10 Damage Survey
- Dimensional Measurement - Inspection Program - Inspection Record - API RP-2A P W
- Visual inspection - Diving Procedures - API RP-2 SIM P W
- Dented - Previous Inspection Record - No damage, corroded or crack P W
- Corroded
- Crack - Design Appraisal Report

- PerMen ESDM No. 32 Tahun 2021

D Under Water Pre-Selected Inspection (Level III Inspection)

1 Weld/Joint Close Visual Inspection
- Detect and Dimensional Measurement - Inspection Program - Inspection Record - API RP-2A P W
- Alignment Measurement - Diving Procedures - API RP-2 SIM P W
- Extend of damage at or adjacent to the weld/joint - FMD Procedure P W
- PerMen ESDM No. 32 Tahun 2021
- Enginering Evaluation

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 INSPECTION AND TEST PLAN
EXISTING PLATFORMS
No. ITP :
Tanggal :
Purpose : INSPECTION (RBUI LEVEL III) for PHE-30
Project : 20050 - RECERTIFICATION SERVICES PHEWMO
Owner : PERTAMINA HULU ENERGY WEST MADURA OFFSHORE
Location : PHEWMO OFFSHORE
PI : PT DEVNUSA ROGA PLANINDO
RBUI Level III INSPECTION
(Under Water Preselected Inspection)

PI : PT DEVNUSA ROGA PLANINDO AR : Approval Required R : Review Document

A : Actual Inspection T/C : Test Certification Required
W : Witness Inspection H : Hold Point
P : Provide M : Monitoring

Inspection Level
No. Activity Reference Verified Acceptance
Document Document Criteria PHEWMO DRP Migas

E. Reporting
1 Field Report
- Inspection Program - Inspection Record - API RP-2A R & AR P
- PerMen ESDM No. 32 Tahun 2021 - Result inspection approved by
QC/NDT contractor, PJIT, and
Owner company

- API RP-2 SIM

2 Final Report
- Inspection Program - Inspection Record - API RP-2A R & AR P AR
- PerMen ESDM No. 32 Tahun 2021 - No significant anomaly
- API RP-2 SIM

PERTAMINA HULU ENERGY WMO PT Devnusa Roga Planindo Migas

Ferdio Giffary

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