DID F SV 39 Form Pre Test Commissioning1

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PRE-TEST COMMISIONING FORM

SECTION 1 : Project Information


Building Name : WISMA INDOVISION 1
Application :
Project Address : JL. RAYA PANJANG BLOK Z/III

Number of Floor : 9TH floors Number of Building :

SECTION 2 : Owner Information SECTION 3 : Contractor Information


Company Name : PT MNC SKYVISION Company Name : PT. CIPTAKARYA PERSADA MANDIR
Name of Staff : BPK. EDUARD TALALAHU Name of Staff :6
Phone number : 81288955215 Phone number : 81901166688

SECTION 4 : Dealer Information


Dealer Name : CV. ERA TEKNIK
Dealer Staf Name : NOVI Phone number : 87784992665
Installer Name/PIC : RIYANTO Phone number : 85218357888
PIC of Field Works : RIYANTO Phone number :
DID Supervisor Name : Phone number :

SECTION 5 : VRV Unit Information


Delivery Date to Site :
Indoor Unit Qty : Outdoor Unit Qty :
Controller Type : Wired/Wireless* Model :
Central Controller Type : Model :

SECTION 6 : Document Checklist (Must be attached to this form)

Yes No As Built Drawing (Must show all unit position, refrigerant pipeline, and drain pipe)
Yes No Equipment schedule from consultant
Yes No VRV Express Data
Yes No
Delivered equipment list (Include: model and serial number)
Yes No Name and Model of every System (Include: Indoor & Outdoor Type and Model, Controller)
Yes No All Schematic Drawing (Piping & Control Wiring)
Yes No Pipe Test Press Report (Already checked & approved at site)
SECTION 7 : Approval
Prepared by, Approved by, Accepted by,

Name : Name : Name :


Position : Position : Sales Manager Position : Service Head
DID-F-SV-39 Rev. 00
A: STORE (GENERAL RETAIL)
B: FACTORY, WAREHOUSE
C: GOVERNMENT OFFICE, PUBLIC OFFICE
D: HOTEL, INN
E: CONDOMINIUM, APARTMENT
F: RESTAURANT, AMUSEMENT FACILITY
G: GENERAL OFFICE
H: HOSPITAL
I: COMPANY DORMITORY, LODGING FACILITY
J: PRIVATE RESIDENCE
K: DEPARTMENT STORE, SHOPPING CENTRE
L: COMPUTER ROOM, SERVER
M: SCHOOL, EDUCATIONAL INSTITUTION
N: STORE, CHAIN STORE
Z: OTHERS
A: STORE (GENERAL RETAIL)
B: FACTORY, WAREHOUSE
C: GOVERNMENT OFFICE, PUBLIC OFFICE
D: HOTEL, INN
E: CONDOMINIUM, APARTMENT
F: RESTAURANT, AMUSEMENT FACILITY
G: GENERAL OFFICE
H: HOSPITAL
I: COMPANY DORMITORY, LODGING FACILITY
J: PRIVATE RESIDENCE
K: DEPARTMENT STORE, SHOPPING CENTRE
L: COMPUTER ROOM, SERVER
M: SCHOOL, EDUCATIONAL INSTITUTION
N: STORE, CHAIN STORE
Z: OTHERS

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