Surat Penyerahan Barang

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PT. PBM.

ELSA JAYA

Head office : Jl. Slamet Riyadi No.09C RT.43 Loktuan Bontang Kalimantan Timur

RECEIPT/DELIVERY
Container Inspection Cheklist
NAMA KAPAL

NO

BENDERA

TANGGAL

HATCH. NO

DRIVER

No. Kendaraan

Deskripsi

Waktu

Dikirim

Diterima

Container Inspection
Nomor Container
No

Inspected

Bagian Atas/Atap

Bagian dalam

Bagian Kanan

Bagian kiri

Dinding Depan

Bagian Belakang

Lantai

Pintu/Kunci

Nomor Segel
Kondisi Container
Baik

Rusak

Penyok

Lobang

Berkarat

Tidak diketahui

Catatan *)

DIPERIKSA OLEH,

DITERIMA

KAPAL

PBM

MENGETAHUI,

EKSPEDISI

SECURITY KNI

:
:
:

Catatan

TY KNI

KNI

TALLY SHEET/DELIVERY/RECEIPT
Name Of Vessel
Voy. No
Loading Port
Discharging Port
NO

DATE

:
:
:
:

Kind Of Cargo
Total
Commenced
Finish
HOURS

HATCH

CONTAINER NO

SEAL NO

Bay No.

LOCATION
Row No.

:
:
:
:

FULL
Tier No.

20"

TOTAL
Aknowledge by,

PT. KNI

Prepared B
PBM ELSA

ULL
40"

d By,
SA JAYA

NETTO

Nama Kapal
Bendera
Loading Port
Discharging Port
NO
NOPOL

:
:
:
:
1

QUANTITY
3

300
300
590
580
1770

CONTAINER INSPECTION CHEKLIST


CONTAINER NUMBER
SEAL NUMBER
IMPORTER
SHIPPER/FACTORY
INSPECTION

KONDISI PE

Front Wall
Blocks and Vents are visible
no hollow sound heards when tapped with a tool
Left Side
no unsual repairs to structural beams
repairs to inside wall are also visible on the outside
no hollow sound heards when tapped with a tool
Right Side
no unsual repairs to structural beams
repairs to inside wall are also visible on the outside
no hollow sound heards when tapped with a tool
Outside undercarriage
support beams are visible (use mirror to view underside)
Floor
Appears flat
only one floor height within container
Ceeling/roof
Blocks and Vents are visible
repairs to inside wall are also visible on the outside
no hollow sound heards when tapped with a tool
Inside/outside doors
Locking mechanism is in good working condition
no loose bolts, plates or repairs
CONTAINER INSPECTION CONDUCTED BY
NAME &DATE
SEAL INSPECTED & AFFIXED BY
NAME &DATE
CONTAINER LOADED BY
NAME &DATE
CONTAINER LOADING MONITORED BY
NAME &DATE

Baik

Rusak

EKLIST

KONDISI PEMERIKSAAN
Penyok

Lobang

SIGNATURE
SIGNATURE
SIGNATURE
SIGNATURE

Berkarat

Tidak diketahui

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