Material Dismantle Form Document Date

OScrap DReturn
Reference Numbers
TSK-MVC-202.30527000784 RAN, MVC-20230527O00785 MW-NE
Task )

Site ) 21181

Site Nane Siantar2

General Information

Delivery Date

e. Header Test
Recciving Plant
Storage Location *f/ faulty pls return to nearby remote warehouse

Recipicnt Nama penerima barang :

DetailInformation
No Material Code Serial Number Oty Completeness Remarks
Description

Rack Huawei TMC11H v NA

21023192314MC2085559,/
MRFU 21023192314MG2072823. 3

212312CFB4MK3000612,
RRU 212312CFB4MK3000622, v
2102130608BTF9000631, V
Module rectifier EPW30-48A 21021306088NA3016655, V 3

BBU390 j21021127226TC2919256
Idu RTN 950 21024131746TC6902478

Combiner NA 6

ODU 15G-2 NA 2 V

Antenna Sektor NA

Antenna MV NA -

Battery Narada 100Ah NA 4

Nybrid isG /

Remarks:

Sent By: Approve By: Approve By:

(Patner) (SPVAita) (SPV IOH) Delivered By: Received by;
Sign Sign:
(Courier/Forwarder)
Sign Sign
Nane : Dody
Nane: Aray Sul1styo Name : Rully Caessaria
Company : PTAMS
Name: Tomly Tobing
Company: APM Company: IOH
Company : PT. AMS
Depart1ncnt: NSRO Depautnent :NSRO Department : NSRo
Comhany: A;iA
Date: 1705-2023 Department: NSRo
Date 17-05-2023 Date
Note Date: 17-05-2023 Date: oS- 0G23
*) Only f/ faulty material
*) Received by: (4itu IWarehouse) dipernuntukkan hanya
khusus Material Dismantle Scrap dan
Return
indosat
OOREDOO HUICHHSON alita
Material Dismantle Form
Document Dote

OScrap Return
Reference Numbers
TSK-MVC-20230527000784 JRAN, MVC-20230527000785 MW-NE
Ste ) 2|181

Site Name Siantar2

General Information

Delivery Date
DN. Header Text

Receiving Plant
Storagc Location *1/ faulty pls return to nearby remote warehouse
Recipicnt Nama pencrima barang
Detail Information

No Material Code Description Serial Number Ot Completeness Remasks

Rack Huawei TMC1H V NA 3

21023192314MC2085569,
MRFU 21023192314MC2072823, 3
212312CFB4MK3000612,
RRU 212312CFB4MK3000622,v
21021306088TF9000631, DTrGOD o6s0 w
Module rectifier EPW30-48A 21021306088NA3016656, 3

RRU3900 / 21021127236TC2919256

Idu RTN 950 21021131746TC6902478 1/

Combiner NA 6

ODU 15G-2 NA

Antena Sektor NA 3

Antenna MW NA

Battery Narada 100Ah e NA 4

Nybrid isG /

Remarks:

Sent By : Approve By: Approve By: Delivered By: Receired by;

(Patner) (SPV Alhta) (SPV IOH) (Courier/Forwarder)
Sign Sign: Sign : Sign :

Nane Dody Nune: Aray Sulistyo Name: Rully Caessaria Nane : Tomly Tobing

Company PTAMS Cornpany:APM Company: IOH Company :PT. AMs Comhgny: GLiA
Departcnt NSkO DpartnIeTIt:NSRO Department :NSRO Departunent : NSRO

Date 17)5-202 3 Date 17-05-2023 Date Date: 17-05-2023

Note
Only f/ faulty material
Received by:1lta Ilurehouse) diperuntukkan hanya khusus Material Dismantle Scrap dan Return