BORDEN CO. (PTE.) LTD.

Appendix 1

No. 9 Jalan Kilang, Singapore 159409

Form SMR.11.L

Starting Materials Record

1.
2.
3.
4.

Date of receipt
Date of Inspection
Standard name of material
Name of material on delivery

note
5. Name and address of
supplier

6. Country of origin of supplier

7. Suppliers Batch/ Reference
No.
8. Unit Identifying No.
9. Total Quantity Received

10. Number of Packets

Label
29 September 2011
29 September 2011
English Text Label, Thailand, 3 ml, (LT3)
FORMULA LABEL (BACK) WITH DATE LIST :
THAILAND 3ML
KOMARK - GENERAL LABELS & LABELLING
PTE LTD
Blk 164 Kallang Way #02-09/10
Kolam Ayer Industrial Park
Singapore 349248
Singapore
KM_LFYS_THAI_3
LT3-11-02
340,000 Pieces
(6 Packets x 5 Rolls x 10,000 Pieces) +
(1 Packet x 4 Rolls x 10,000 Pieces)
7 Packets
(34 Rolls)

Received
11. Number of Packets
NIL
Damaged
* Refer to Form CPM
12.1 DO No. & date
91180KA dated 29-09-2011
12.2 Purchase Order No. & date PO1109/026 dated 16-09-2011
13. Remarks:
13.1 The Goods are inspected by Laboratory Technician with the assistance of
the Storekeeper.
13.2 Provide the Quarantine status labels to the Storekeeper and instruct him
to paste the labels on each packet.
13.3 Instruct the Storekeeper to store the goods in the Quarantine Area.
13.4 Choose 1 roll each from 2 packets, total 2 rolls, take 10 pieces from each
roll, total 20 pieces, randomly, for further tests.
Sample Calculation: 0.4 x 34 = 2.33 2 rolls
PO quantity:
340,000
DO quantity for this delivery:
Pieces
340,000 Pieces
PO completed.
Remaining balance after this delivery:
NIL
Inspected By (Signature):
Name:
Designation:
Department:
Date:

William Chandra
Quality Control Technician
Quality Control Department
Thursday, September 29, 2011

Ref. SOP. NO. 107.8

Edition: 6

Date Effective: 01 June 2011

BORDEN CO. (PTE.) LTD.

Appendix 1

No. 9 Jalan Kilang, Singapore 159409

Form SMR.11.L

Starting Materials Record

Description of Item
Received
Quarantine status label

Label

Quantity
(Pieces)
7

Received by
(Initial)

Date
29 September 2011

* Number of Quarantine labels printed: 8. Identical copy of Quarantine label is attached to

this document.

Ref. SOP. NO. 107.8

Edition: 6

Date Effective: 01 June 2011