SERVICE ORDER FORM

COMPANY NAME : PT ANUGERAH INDOFOOD BAROKAH MAKMUR

Address Jl Jenderal Sudirman no 23

Ungaran Contract Ref. 008/PKS/AIBM-UNG/IV-2019
PIC Jarot Ibnu Wibowo Quo. Ref. 208/PPLI-SA/IV-2019
Phone 0246921670 PO Ref.
Email jarot.wibowo@aibm.co.id

Dear PPLi,
I’d like to order of waste transportation and disposal of waste as described as below :
Qty
No Profile # Waste Description Code (ton) Unit Unit Price (Rp.) Total Price (Rp.)
Aki Bekas (Used A102d 2 box = 900.000/200 lt
#37539
1 Accumulator) #37539 0.16 0.149 M3 = 4500000/ m3 670.500
Neon Bekas (Used lamp) B107d 6 box = 950.000/200 lt
#23481
2 #23481 0.0194 0.447 M3 = 4750000/ m3 2.123.250
Kain majun bekas
#23482 #23482(Contaminated B110d 1 box = 650.000/200 lt
3 Good/Used Rag) 0.0175 0.074 M3 = 3250000/ m3 240.000
Reagent sisa (Lab Waste) A106d  0.019 1 box =  900.000/200 lt
#23480
4 #23480 7 0.058 M3 = 4500000/ m3 261.000 
Tonner (Used Ink Bottle) B339-
#38957  0.011 3 box =  600.000/200 lt
#38957 2
5 8 0.207 M3 =3250000/ m3 672.750 
Botol/ jerigen Ex Laborat B104d 4 box = 600.000/200 lt
#47664
6 (Empty Cemical Packaging) 0.0180 0.349 M3 =3250000/ m3 1.134.250
1.500.000/200
Kimia Exp (expired Cemical) A106d
#27103 1 box = lt = 7500000/
#27103
7 0.0094 0.058 M3 m3 435.000
Battery bekas (Used A102d 1 box =
#27104
8 Battery) #27104 0.004 0.026 M3 250.000/25 kg 250.000
Fillter Olie (Used oil filter) B109d 3 box = 600.000/200 lt
#38956
9 #38956 0.0255 0.191 M3 = 3250000/ m3 617500
Kemasan Catridge, Tonner B339-
#37538 #37538 (Used Cartridge & 2 2 box = 650.000/200 lt
10 Tonner) 0.0085 0.093 M3 =3250000/ m3 302.250
Elektronik (Elektronik B107d 1 box = 650.200/200 lt
#27102
11 Waste) #27102 0.0120 0.058 M3 = 3250000 188.500
Resin Kation – Anion (Resin B106d 4 box =
#38873
12 Kation-Anion) #38873 0.120 0.298 M3 200.000/25 kg 960.000
13 Transportation Charge 2 pallet 750.000/pallet 1.500.000
Grand Total (Excluding VAT10%) Rp. 9.355.000

Note :
1. Invoice based on actual received in PPLi Facility
 2. Actual Packaging based on quotation reference
3. If any differences between Service Order and Quotation Letter, PPLi having authority to convert
as incoming without confirmation to the customer

Prepared and Send by

PT. Anugerah Indofood Barokah Makmur

Name : Jarot Ibnu Wibowo

Title : HSE Staff
(Signed and Stamp)

FOTO ACTUAL LIMBAH B3 DALAM KEMASAN

1. Aki bekas
2. Neon Bekas

3.Kain majun bekas 4. Reagent sisa

5.Tonner 6. Botol jerigen ex laborat

7. Kimia Expired 8. Batere bekas

 9. Filter Oli 10.Kemasan Catridge

11.Elekt r
onik 12. Resin anion kation