No:..............................

Surat Jalan / Tanda Terima Barang

Delivery / Receiving Note
KEPADA / ATTENTION TO
Nama Pelanggan : PT. Japan Drilling Company Company Name : PT. TRAKINDO UTAMA
Costumer Name Cabang / Branch : BALIKPAPAN
Alamat / Address : Alamat / Address : JL. PULAU BALANG KM.13 RT.33
Hakuryu - 14 Rig KEL. KARANG JOANG
BALIKPAPAN 76127
Contact Person : Mr. Agus / Mr.Rudi (Chief Mechanic) Contact Person : DONAL SUDRAJAT
Phone / Fax. : Phone / Fax. : 0811-5431022
INFORMASI PENGIRIMAN / DELIVERY INFORMATION INFORMASI DOKUMEN / DOCUMENT INFORMATION
Jasa Pengangkut / Forwarder : Document No. :
Tipe Kendaraan / Vehicle Type : Document Date :
No. Polisi / Police No. : Equipment Model : C175
Tanggal Kirim / Delivery Date : December 21, 2022 Serial No. / Arr No. :
Lokasi Tujuan / Destination : Hakuryu - 14 Rig Work Order No. :

PERINCIAN DAFTAR BARANG / PACKING LIST DETAIL*

Jumlah / Satuan /
Nama Barang / Items Name Keterangan / Description
Qty Unit
1 TORQUE WRENCH (75, 250 & 600) 3 EA
2 INFRA RED 1 EA
3 SENDER & GERINDA 2 EA
4
5
VIBRATION TEST
CONSUMABLE BOX
1
1
EA
BOX
do
6 TOOLBOX 1 EA

i n s
k l
7 CHEMICAL 1 EA

ra oo
T T

On Behalf of PT. TRAKINDO UTAMA Security On Behalf of Customer

Name Date : Name Date : Name Date :