Bulk Production Batch Record

Order No. 001 DS SOURCE UNIT | BORNEO Page: 1 of 5

Product Code Product: Wild Borneo Green Batch Lot
GH Mitragyna speciosa GH-001-DS
Name Signature Date
Prepared by Date of
QA Officer, Manufacture
Source Unit, Borneo 24-Nov-20
Approved by Expiry Date
QA Manager TBA
Head Office

1. PRODUCT DETAILS
Description Bulk Product: 20kg units
Form: Milled Powder | 03 screen
Variant: Green
Bulk Production 1,000kg (50 x 20kg)
Batch Quantity

Packaging Units of 20kg

Storage Conditions Cool, dry and dark

2. BULK PRODUCTION BATCH RECORD ISSUANCE

ISSUED BY: Issuer has reviewed the Batch Record to ensure that the copy is complete and
accurate copy of the Master Batch Record and includes records contained within the Past-Harvest
Production Batch Tracking Sheet.
QA Officer. Source Unit, Borneo
Print Name: Signature Date

ISSUED TO: QA Manager has reviewed the Batch Record to ensure that the Record is complete
and correct and is now responsible for the Batch Record and coordinating with QA Officer,
Surabaya to ensure the Batch Record is tracked and recorded through to Finished Product Batch
Release and Export.
QA Manager. Head Office
Print Name: Signature Date

3. SOURCE UNIT CODES | BORNEO

DS = Source Unit ‘Dua Suadara Berkarya’
AG = Source Unit ‘Agus’
BT = Source Unit ‘Borneo Treasure’

BATCH NUMBER MANUFACTURING DATE EXPIRY DATE

GH-001-DS–0-329-A 24 November 2020 TBA
 Bulk Production Batch Record Page: 2 of 5
Order No. 001 DS SOURCE UNIT | BORNEO
Product Code Product: Wild Borneo Green Batch Lot
GH Mitragyna speciosa GH-001-DS
Name Signature Date
Prepared by Date of
QA Officer, Manufacture
Source Unit, Borneo 24-Nov-20
Approved by Expiry Date
QA Manager TBA
Head Office

4. RAW MATERIALS
Description Ingredient Fresh Leaf Qty Fresh Leaf Qty Quantity Verified By/Date
Code Required for Harvest Lot Staged
Batch (kg) Area Codes
Mitragyna MSG
speciosa |
Green

5. PROCESSING EQUIPMENTS
Equipment Description ID No. Screen Size Equipment Performed Verified
Clean-Down By/Date By/Date
Milling Machine M-01 03
Ganesha 45cm
Milling Machine M-02 03
Ganesha 45cm
Milling Machine M-03 03
Ganesha 45cm
Milling Machine M-04 03
Ganesha 45cm

BATCH NUMBER MANUFACTURING DATE EXPIRY DATE

GH-001-DS–0-329-A 24 November 2020 TBA
 Bulk Production Batch Record
Order No. 001 DS SOURCE UNIT | BORNEO Page: 3 of 5
Product Code Product: Wild Borneo Green Batch Lot
GH Mitragyna speciosa GH-001-DS
Name Signature Date
Prepared by Date of
QA Officer, Manufacture
Source Unit, Borneo 24-Nov-20
Approved by Expiry Date
QA Manager TBA
Head Office

6. PROCESSING CLEARANCE
Step Performed By/Date Verified By/Date
1. Review the Processing Area and verify
that Cleaning has been performed
according to Facility Cleaning
Procedures Policy.

2. Verify that the Processing Area does not

contain any items from previous batches
or cleaning activities and that no items
unrelated to the current batch are
present.

3. Processing clearance complete.

QA shall complete the Processing
Clearance Sign and affix it to the
Processing Area entrance.

7. PRODUCTION PROCEDURE
Processing Step Performed By/Date Verified By/Date
1. Dispense and weigh the Raw Materials
as noted in Part 4

2. Mill/powder the dry Mitragyna speciosa

leaves into fine powder with the Milling
Machines (IDs: M-01; M-02; M-03; M-
04) using 03 Screen

BATCH NUMBER MANUFACTURING DATE EXPIRY DATE

GH-001-DS–0-329-A 24 November 2020 TBA
 Order No. 001 Bulk Production Batch Record Page: 4 of 5
DS SOURCE UNIT | BORNEO
Product Code Product: Wild Borneo Green Batch Lot
GH Mitragyna speciosa GH-001-DS
Name Signature Date
Prepared by Date of
QA Officer, Manufacture
Source Unit, Borneo 24-Nov-20
Approved by Expiry Date
QA Manager TBA
Head Office

8. BULK PACKING PROCEDURE

Step Performed By/Date Verified By/Date
1. Transfer the fine powder into suitable
food-grade 20kg bulk bags. Securely
seal.

2. Label the food-grade bulk bag

a) Order Number
b) Product Code
c) Harvest Zone Code (if applicable)
d) Net Weight
e) Bulk Production Batch Number

3. Pack into Outers for Storage and

Shipping to the Processing Unit.

9. STANDARD OPERATING PROCEDURES (SOP) COMPLIANCE

This confirms the supporting Standard Operating Procedures (SOPs) have been followed:
1. Field Management Practices for Mitragyna Speciosa Stands
2. Leaf Harvest of Mitragyna Speciosa Stands
3. Post-Harvest Bulk Production Procedures
4. Bulk-Production Batch Coding System
5. Hygiene

Name Signature Date

Production
Quality Assurance

10. YIELD CALCULATION

Yield = 100 % x Bulk Milled Product + Rejects + Samples ÷ Weight of Whole Leaf Raw
Materials
= _______ (Specification: XX – YY %)

BATCH NUMBER MANUFACTURING DATE EXPIRY DATE

GH-001-DS–0-329-A 24 November 2020 TBA

Order No. 001 Bulk Production Batch Record Page: 5 of 5

 DS SOURCE UNIT | BORNEO
Product Code Product: Wild Borneo Green Batch Lot
GH Mitragyna speciosa GH-001-DS
Name Signature Date
Prepared by Date of
QA Officer, Manufacture
Source Unit, Borneo 24-Nov-20
Approved by Expiry Date
QA Manager TBA
Head Office

11. POST-PRODUCTION BATCH REVIEW

The complete Post-Production Batch Record has been reviewed for completeness and accuracy.
All pages are complete and all entries conform to Good Production Documentation Practices.

Name Signature Date

Operations Manager
QA Officer
QA Manager

12. BULK PRODUCTION BATCH RELEASE

The material produced through the execution of this Batch Record is hereby verified and released by
QA according to Product Release Procedure SOP.

The product conforms to Bulk Product Specification: Wild Borneo Green (GH)

Certificate of Authenticity (COA) No: ___________ Date: ____________

Name Signature Date

Operations Manager, Borneo
Quality Assurance Officer,
Borneo
Quality Assurance, Manager.
Head Office

BATCH NUMBER MANUFACTURING DATE EXPIRY DATE

GH-001-DS–0-329-A 24 November 2020 TBA