a PT. PERTAMINA (PERSERO) g# INTEGRATED TERMINAL SURABAYA LPG FILLING PLANT PERTAMINA Jl. Nilam Barat 37, Tg. Perak Surabaya Telp (031) 3281574, Fax. (031) 329 4215 BUKTI PENYERAHAN PRODUK Dari : Depot LPG - Tg. Perak, Surabaya Dikirim Kepada : SPPBE - PT. PERTAMINA INTERNATIONAL TIMOR, SA No. PNBP :8099165520/0 No. Polisi 1.8704 UM (11 MT) Posisi Timbang _ : Selatan RG 193% Sp. Gravity 70.5448 % C3IC4 : 46154 No. Data 12309210082 No. Segel 1 E-174508 (1) SKID TANK KOSONG MASUK vf Waktu : 21-09-2023 10:39:37 <2 Tara 120,230 kg s _ SKID TANK IS] KELUAR Waktu 2 21-09-2023 11:51:30 Bruto 131,530 kg Netto 111,300 kg - Operator :A. HAIMAN Tg. Perak, 21 Sep 2023 Pengawas : MABRUR wv *) Struk dicetak otomatis oleh sistem, dokumen ini sah walau tanpa tanda CF tangan pejabat berwenang. yer R_ - = Lembar PUTIH untuk SPPBE/Transportr/Agen —— > Lembor MERAH entuk Gate Keeper ~ Lembar KUNING urtuk Jenbaten Timbang Dipindai dengan CamScannerCompany oY PERTAMINA INTER ETIMOR, S.A. AVENIDA LURO MATA NO. 10 DOM ALEIXO MUNICIPIO DE DILI, TIMOR LESTE 00000 DIL! a Loading Order s* PaRTAMIL Plan Gl Date : 21.09.2023 PATRA NIA ‘Shipping information Delivery note numberidate —» 8099165520 / 21.09 2023 Customer's PO numberldate . 4026252087 Order numberidato 4026252087 / 19.09.2023 EAST TIMOR Customer number a. SEP 2 2023 Conditions Vehicle - Diver Shipping: standard Vehicle number: Delivery “FOB Dawerunber B70 Y Ue . Ship From : Depot FP Tg Perak Surabaya Filling point . Sealmumber fee patel Quantity Description 000010 (A050410001 11,300 MT LPG MIXED, BULK Reference number 4025252087 DEPOT LPG TG.PERAK ul Dipindai dengan CamScannerCARSURIN 1968 LAPORAN SURVEYOR EXPORT SURVEYOR EXPORT REPORT MINYAX BUM, GAS BUMI, DAN BAAN BAKAR LAIN | PETROLEUM, NATURAL GAS AND OTHER FUELS SEBATURAN UENTERLPEROAGANGANLRING 202025 VR No, VREOI791 |. Parties Concomed Exporter /Eksportir Name / Narra ‘Address / Alamat ertamina Patra Naga Gedung Wisma Tugu Lt 2, J Ls No. ts202309-S841 Importer! Importir Name ! Nama ‘Address / Alamat HR. Rasuna Said Kav. © 7-9 Kuningan, Karet Setiabud, Jakarta Selatan Country Negara Inconesia Newe (070614572051000, SPE No 03 PE-05.23.0017 SPE Date. 2701/2028 NoET + 03,67-05,15,0068.1 ET Date. 2aror2023 1. Shipment Data / Data Pengiriman Mode of Transportation / = Sea Moda Transportasi Vessovsreraft (Nama Alst = MT. Moratus Samarinda Angkut) Voyage No. / No, IONE Pengiiman County of Origin | Negara. = Indonesia Asal Port of Loading / 7. Perak, Surabaya Plabunan Aunt Port of Discharge / a Pelabuhan Gongkar Place of inspection 7. Perak, Surabaya ‘Tompat Pemeriksaan IL Detais of Goods Inspected / Rinclan Barang County / Negara lvoice No Invoice Date /Tanggel Invoice LCNo LC Date Tangge! LC BL Doe No BL! Doc Date ‘Tanggal 8L ate of Inspection / Tanggal Pemeriksaan F¥.04.L9P_rev.01.2018 Date of LS Expired : 21/10/2023, Pettamina Intemational Timor, SA Rua Para os Goqueiros Dom Alexo Bil, Tipor Lesje TIN 1236288 Timor Leste ‘siLPIK2028 201092023, +: SUBSE2057192 24ro92023 0109/2023 Quantityueit Weight/ Borat Date of issuad / Tanggal Teri, Issuing Office / Kantor Penertit PT CARSURIN, Tbk 71300,000 KEM 2092023 ekarta ($ 15331 Dipindai dengan CamScannerCARSURIN see FM31.MR ‘AOB / COGS / PET / 2309 - 0836 Mengacu kepada Aeferto: 'No SPK: No. 874/PNC430000/2023-50 dai PT, Pertamina Patra Niaga pada tanggsl 20 September 2073 ‘Dengan ini kami menugaskan : We herewith assign our staff (s) as here under: ._Name : Filip Surindo Simatupang TO No : 1208071211970001 ] ‘Untuk melaksanakan tugas To carry out duty: ‘1. Verifikasi Teknis Ekspor Spy LPG Mix abt: 11.300 KG Isotank BEIU 8068774 - MT Meratus Samarinda ALD : September 20, 2023 Di: ate “Tanjung Perak, indonesia Atas permintaan_ Based on request of Mest: PT. Pertamina Patra Naga ‘Surveyor membawa alat-alat yang diperiukan The surveyors equipped with the needed equipment to untuk melaksanakan tugas di atas dan akan perform the task assigned, and will perform the job with melaksanakan tugas dengan mengutamakan the utmost possible quality and integrity. kualitas dan integrtas. Masa surat ugar adalah The vty of thi axignment wil be: we. ari chon bantuanny, danuntukitu Kami We equest your assitance os required of which we wcapkanterima kash thank Jokorto, September 19, 2023 PTCARSURIN , Head of Operation Sign: . 5 CARSUNIN ‘Saya menerima tugas yang dberikan dan accept REG assigned and do perform i professionally melaksanakannya secara professional, dengan and with the utmost quality and integrity. kualitas dan integritastertinggi. Surveyor yang ditugaskan: Assigned Surveyor: 1. Filip Surindo Simatupang Siem Diketahui oe ‘AcknoWedged by: ‘Manager Product Operation Zaenal Agus Sypkur 1. Terminal Sey 2, Vessel Sie Seperba 0F4 Rev "Ws reort ett ur figs tne ad pce ol speetoiestng ely ands hereby given secardrg our prtesona standards nd tot best cur knowledge ut wth peje tomas any gut of ts anor aby any part eoncerec Out espns nted {othe eeteeofreasanabie cate, The Croany sill vesponstetoany pate on any busines, rane ano legal eonzequeee or any Wanton by wang Ns Fear ena, This document camot be reproduced eceptin ul wAhoat por approval the Congany, Dipindai dengan CamScannerEs CARSURIN 1 Mengacu Perjanjian Pengadaan Jasa Survel (Surveyor) untuk Kegiatan Muat Kargo Ekspor Produk dan LPG (LS) Periode 2023 antara PT Carsurin dengan PT. Pertamina Patra Niaga No. 3950250681 tanggal 1 Januari 2023, bersama ini kami sampaikan nama-nama petugas surveyor yang akan bertugas adalah sebagai berikut : Nama Kapal : MT Meratus Samarinda Jenis Kargo + LPG Mix Tanggal Survey + 20 September, 2023 Terminal : Tanjung Perak, Indonesia Petugas Survey + 1, Fhilip Surindo Simatupang ~ Hp No. 0813-9264-5401 KTP ID CARD Petugas surveyor yang bertugas adalah benar sesual dengan nama yang tercantum diatas. Penanggung jawab Mengetahui, Di Terminal pManaser Product Operation Zaenal Agus Syukur ‘Ths rept eft ow tncngs a tine ad pace repent ot an seb oon ‘xcardg lo oy prefs Sarda and he be tur trode at bon refs toverds ry asta iis er Wy exo pory eens, OF ress ted tothe eee ete The Cnn at ft Pre Dipindai dengan CamScannerCc CARSURIN 1968 Tanggal : 19 September, 2023 Perihal : Tanda Kehadiran Kegiatan Survel Verivikasi LS Isotank - MT Meratus ‘Samarinda - ALD 20 September, 2023 Bersama ini kami sampaikan bahwa nama-nama yang disebutkan sebagai berikut: 41. Fhilip Surindo Simatupang Adalah benar petugas surveil dari PT Carsurin yang hadir dalam kegiatan survei di Tanjung Perak selama hari malam. Demikian surat tanda kehadiran kami buat dan dipergunakan sebagaimana mestinya. Petugas 7 Terminal Representative “2 a Fhilip Surindo Simatupang «:jokata@carsurincom “Wreteedso degs ate ad ze eta dey en Tesg scr pecnorasaranés ented cr oye ba ae psc ‘ovr ot eaten sedate oy pr eres repels ed bec deen ory at asa et py ‘nar moc encore sean am waracany ey Bier ee a iment be ewes eer htt re ee ee Dipindai dengan CamScannerNIungavo III 0 62.9 AM 4 ‘erowop 'soyendon s0q eeig eny: —eWeIY/ SSa:PPY —IN'Z TTL NENy CURIA BUMPED ewery /80290Y ‘vs vou revonewenu eueLeg : ‘owen / OWEN eben ened euweved ewe / OWEN snvodun juayodiut snuodexa | 9083 Peweauon served ezozsoriee : pee $10 160 ‘S$85-60€z02S1 "ON 51 SOBTORUA “ON WA aver Niunsuvo eS Dipindai dengan CamScannereo wnnesBecrnd s ‘meee neo cue re any ee nag eoxsoreneoien ¢ mignon ae ‘une VOVINWalVd is youniysa ae ss TnyRAS smBy feusezZ lvojesado vonporg saBeUeN Aq pabpamouvry =yaI0 MUETONG, ‘Suedmiewis opuuns dius _"T ‘AuB2puy puo Axyanb 1SOwIN 2Y3 YAM PUD ‘Ajouossafoud y wofred op puo paubisso gol ayn 142200 “ueyseinp Buek Onan -y88upuo1 sexy 00u) uep seayen leap ‘jeuojssajoud exe29s efuueyeuesyelaul ep ueyu9qip ueA sem ewrauaw ehes TeMURTSL VEU EY uotesado 4 pe9H ‘ord 73 A WUIUD SSO Jo ANON PU ‘Ayubaiu po ksonb 2jqissod ysowan 243 yam gol a4) wsofsad yum pd ‘pausso ys0) ayn wuofiad 03 uawdinba papaeu aya yum paddinba 5) soanuns ayy [ THBS@A Jo aNBSI UO PasOE ‘MNSHVO Id ez02 ‘cz s9qwaidas ‘ouoyor ‘sey ewsay ueydean wey my ymun uep ‘ekuuemueg woyou {wey THRIRDE 10 Seam TEINS OSE ueyewernduaw veBuap sem ueyevesyeaus ueye uep seve 1p sem veyeuesyeaus mun uejnuadip #ue4 Yejeeje emequaus shaKns WOVIN VULVA WRIPIVINSA 1] " ueeIUued Fay eisauspuy enquieiy "nana Hv ‘inp 0 A103 Of TOE Te GUNES — ST aE IMAY BRINE OdNE TAL REIEA T+) ‘@ seing ueyeuesyejaw m0 TOOOLETTETZOB0T ON GL Buedayeus opuuns mM OwEN —T "aapin 2704 50 (5) fous sno uss yu 3224 2Mh weysefinuaus jwey ju) weBuIa 05-£202/0000€¥9Nd/628 “ON 4S N2eBuoW! Uep EzOZ WenUeT T 1e88Ue) TE9OSZOSGE ‘941 Uep ynpo1g 104543 08Jey YeNWY Ueve/B9y yMIUN (JOKanIns) |aRNS eseF LEePEBLAg UE #cor TaquiaNdes Oz eBHUCL apoued (51) jeBuap rensas = 01 3a Tepeday noedvany 9480 ~ 60€7 / 13d / S902 / BOV INGI ri SdO'T'Wd sot Niunsava Dipindai dengan CamScannerG CARSURIN 1968 ‘Sesuai dengan Perjanjian Pengadaan Jasa Survei (Surveyor) untuk Kegiatan Muat Kargo Ekspor Produk dan LPG (LS) Periode 2023 No, 3950250681 tanggal 1 Januari 2023 dan dan mengacu SPK No. '879/PNC430000/2023-S0 Tanggal 20 September 2023, bersama ini kami sampaikan nama-nama petugas surveyor yang akan bertugas adalah sebagai berikut: Jenis Kargo Avtur ‘Tanggal Survey + 27 September, 2023, Terminal + Atapupu, Atambua, Indonesia Petugas Survey #1. Fhilip Surindo Simatupang ~ Hp No, 0813-9264-5401 KP etugas surveyor yang bertugas adalah benar sesuai dengan nama yang tercantum datas, Penanggung Jawab Mengetahui, Di Terminal ‘Manager Product Operation a . ERTAN: AG 4 BATRA Zaenal Agus Syukur 1 johanageanurn com Dipindai dengan CamScannerG CARSURIN 1968 Tanggal : 27 September, 2023 Perihal : Tanda Kehadiran Kegiatan Survei Verifikasi LS AVTUR Tanggal 27 ‘September, 2023 Bersama ini kami sampaikan bahwa nama-nama yang disebutkan sebagai berikut: 1. Fhilip Surindo Simatupang ‘Adalah benar petugas survei dari PT Carsurin yang hadir dalam kegiatan survei di ‘Atapupu, Atambua selama hari alam Demikian surat tanda kehadiran kami buat dan dipergunakan sebagaimana mestinya. Petugas 7 Terminal Representative a - RERTAMINA PATRA NIAGA Fhilip Surindo | ~fAwan Gatto Simatupang :katagcoreuin com Dipindai dengan CamScannerTIME SHEET. Vessel: TRUCK Port + PERTAMINA TBBM ATAPUPU, ATAMBUA "ACTIVITIES (LOADING) Product: PERTAMAX Date: September 27, 2023 DATE FM.01.PET [Surveyor Arrived ‘September 27, 2023 16,30 Key Meeting Held ‘September 28, 2023 | 0840_- 08,45 [Tank Inspection ‘September 28, 2023 | 08,45 - 09,30] [Commenced Loading Truck No. DH 9246 EE ‘September 28, 2023 08,50, [Completed Loading ‘September 28, 2023. 09,50 Document Completed September 28, 2023, 10.44 Prepared By, CAy RIN Simat |Remarks: Truck loading only started on September 28 due to a HSE inspection 9 Dipindai dengan CamScannerCERTIFICATE OF QUANTITY (Issued by An Independent Surveyor) We, the undersign surveyor does hereby declare that the quantity of "AVTUR™ was delivered to the truck tank by metering Is as follows : Initial Flowmeter 95800138 Liters Final Flowmeter 1 __ 95815138 Liters ‘Quantity Loaded 115000 Liters / 94 Barrels “The following particulars should be as additional reference = Cargo Description 1 PERTAMAK = Number of Truck 1 DH 9246 EE ~ Date of Outward Manifest ‘September 27, 2023 = DO Number 18099404629 / 27.09.2023, = Loading Port :TBBM Atapupu = Consignor + PT. Kilang Pertamina Internasional = Consignee + Pertamina International Timor, S.A = Destination + DPPU Komoro, Dill - Timor Leste ‘The above stated quantities have been determined based upon dynamic measurement system PT, CARSURIN CARSURIN Dipindai dengan CamScannerLETTER OF SEALING FM.15.PET TRUCK Product + PERTAMAX PERTAMINA TBEM ATAPUPU, ATAMBUA Date: September 27, 2023 To + 1. Masters) + 2, Terminal Representative *) Dear Sir, ‘We, the undersigned surveyor, according to our Principat’ Instruction with refer to the standard procedure, hereby would lke to draw your attention for sealing the following points/holes: Points ‘Seal NO, Points Seal No. Bridger No, DH 9246 EE 1857106, 1857107 1857108) 1857109) 1857110 1857111 Points Seal No. Points Seal No. ‘Those points were sealed by using Government 's Company seal and witnessed by the Surveyor’s / terminal's representative, *) ‘The seals should be Intact at their places/points and we hold you to responsible if any broken seal found ‘Priorte / upon completion *) of the activities. prior te / upon completion *) of the activites. ee: Chose poprate one 8 Dipindai dengan CamScannerBILL OF LADING re PERTAMINA NO. 5610623B086 SHIPPED in apparent good order and condition by _PT PERTAMINA PETROCHEMICAL TRADING - on board the INDONESIA SSIMS ____ MT. SUCCESS ENERGY Xxx Where of CAPT. HASANUDDIN: is Master, at the port of ‘TUBAN, INDONESIA _ ‘aquantity in bulk as below and to be delivered (subject to the liberties, conditions, exceptions and limitation here! after contained) in the like order and condition at the port of __ a“ CCIWANDAN, INDONESIA, ‘oF 60 near thereunto as he may safely gel and there discharge unto, __CONSIGNEE TO THE ORDER OF BANGKOK BANK PUBLIC COMPANY LIMITED NO. SKBDN 10110571541 16.06.2023, ©are anon °F Order on payment of freight in accordance with the charfer parly hereinafter mentioned or faling such mentoned 10 freight shall be deemed to be earned on commencement of Lading Any freight prepaid to be non-returnable, vessel sy lost or not lost. NOTIFY PARTY commoorry PARAXYLENE IN BULK Long Tons Metric Tons US Barrels @ 60°F Kilo Litres @ 15 °C 6,909.104 Density @ 15°C 0.845 Temperature @ °C 316 | 31.6 Equipment Custody Transfer (ECT) = Manual Dip ‘Where it is impracticable to ascertain should be stated as approximate. 14 Woight, quantity, quality, grade and coy ‘not accountable for leakage. 18 16 — 7 Between 18 and a = as Chaterer, 19 Ch Ta pt the rate and payment of freight specified therein 20 this shipment. . 2 Freight shall be deemed to bff eamied on commiengsment of lading. 22 Clauses 1 to 8 inclusive h the reverse of this/Bill of Lading are incorporated herein and form part of this 23, Bill of Lading. VI 24 IN WITNESS whereof the Master of the said Véésel hath affmed to _3(THREE) Bills of Lading all of this. 25 tenor and date, one of which being accomplished, thf other(s) to stay void. Dated at ‘TUBAN, INDONESIA _ this _20th_—dayof June,2023 8 CAPT. HASANUDDIN: 7 Master of MT, SUCCESS ENERGY XXXI 28 Dipindai dengan CamScannersf” PERTAMINA CARGO MANIFEST VESSEL MT. SUCCESS ENERGY XXXII FLAG INDONESIA BILL OF LADING NO. 5610623B086, DATE June 20, 2023 SHIPPER PT PERTAMINA PETROCHEMICAL TRADING CONSIGNEE TO THE ORDER OF BANGKOK BANK PUBLIC COMPANY LIMITED PORT OF LOADING TUBAN, INDONESIA DESTINATION CIWANDAN, INDONESIA Nunberet COMMODITY GROSS WEIGHT Packages 01. | Grade: PARAXYLENE IN BULK NET GROSS 6,909.104 7,019.747 51,163.79 8,130,270 CAPT. HASANUDDIN Master of MT. SUCCESS ENERGY XXXII Tuban, June 20, 2023 PT. KILANG PERTAMINA INTERNASIONAL Representative, env: inv ACCOUNTING wn a pERTANINNA . oo) Prakmmana ADHITY NEGARA Dipindai dengan CamScannerSs” PERIAMINA CERTIFICATE OF QUANTITY VESSEL NAME : MT, SUCCESS ENERGY XXXIL FLAG 1 INDONESIA MASTER NAME CAPT. HASANUDDIN BILLOF LADING NO. : 56106238086 DATE + June 20,2023 SHIPPER : PTPERTAMINA PETROCHEMICAL TRADING _ CONSIGNEE : TO THE ORDER OF BANGKOK BANK PUBLIC COMPANY LIMITED PORTOFLOADING : TUBANINDONESIA - - PORT OF DISCHARGE : CIWANDAN, INDONESIA NETT QUANTITY Number of | DescRIPTION OF GOODS Packages | LONG TONS METRICTONS | US BARRELS @ 60°F | KILO LITRES @ 15°C. 01. | Grade: PARAXYLENE| — 6,909.104 7.019.747 51,163.79 8,130,270 IN BULK I HEREBY CERTIFY THAT THIS MANIFEST IS COMPLETE AND CORRECT TO THE BEST OF KNOWLEDGE AND BELIEF. PT. KILANG PERTAMINA INTERNASIONAL Copfirmed by. Representative, ; rh exc fe URIN eniLiP 'SUkinpo s ADHITA SI PT. Carsurin Dipindai dengan CamScannerSs" CERTIFICATE OF ORIGIN PERTAMINA IT IS HEREBY CERTIFIED THAT THE UNDER MENTIONED CARGO IS OF INDONESIA ORIGIN 1. VESSEL : MT. SUCCESS ENERGY XXXII 2. FLAG : INDONESIA 3. BILLOF LADING NO. : 56106238086 4, DATE : June 20,2023 . 5. SHIPPER : PT PERTAMINA PETROCHEMICAL TRADING 6. CONSIGNEE : TO THE ORDER OF BANGKOK BANK PUBLIC COMPANY LIMITED 7, PORT OF LOADING —: TUBAN, INDONESIA 8. DESTINATION : CIWANDAN, INDONESIA commopiry DENSITY NETT QUANTITY @1s°c LONG TONS METRICTONS — |US BARRELS @ 60°F | KILO LITRES @ 15°C ARAXYLENE IN BUL| 0.8645 | 6,909.104 7,019.747 51,163.79 8,130.270 PT. KILANG PERTAMINA INTERNASIONAL Representative, qgsTTBY ACCOUNT BA PeRTAAINA y ADHITA SETYA NEGARA Dipindai dengan CamScannerPT Kilang Pertamina Internasional > 27> PERTAIINA,, Hanae TANK TICKET CLOSING DIPP datas Doc Wo + 0059/PS/LO/VI/2023-52 pate 2 20 un 2023 [Time 01:30 Hanke No s20To13 bro IMT SUCCESS ENERGY }OOAI/IETYOS product + PARAXYLENE lip Hole + 18160 [Pita oO (mm) leanculan 10 (mm) |Kosongan (mm) [Oil & Water soz (mm) |Water 20 (mm) Jou Height + 9592 (mm) Lemp 1 3u6 fos) |G PEFROCHEMICAL INDOTAMA Surveyor =a) Fhillp Suri =P Log Printed : 6/2072075 3: tuiseioy CARSURIN 1968 13. AM WIB Log Created : rsudarwanto 19 Jun 2023 23:39:23 Log Updated : rsudarwanto 20 Jun 2023 Dipindai dengan CamScannerPT. Trans-Paci TPPI Petrochemical Indotama BERITA ACARA PENYERAHAN PRODUK OLEH PT. TPPI KEPADA PT. KPI DI KILANG TUBAN - JAWA TIMUR No. TPPI/BAPP/VI.23/086 Hasi / Tanggal Tempat Selasa, 20 Juni 2023 Kilang TPPI Tuban Pada hari Selasa, 20 Juni 2023 telah dilakukan penyerahan dan verifikasi atas quantity produk dari kilang Tuban, sebagai bagian Perjanjian Pengolahan Bahan Baku Kondensat dan Naphtha antara PT. Kilang Pertamina Internasional dengan PT. Trans Pacific Petrochemical Indotama, sebagai berikut; Quantity dikirim ‘Tank MT. SUCCESS ENERGY XXXII 1, Pengiriman dengan 2. Produk PARAXYLE 3. Pelabuhan Muat Kilang TPPI Tuban 4. Pelabuhan Bongkar Ciwandan, Indonesia 5, Surveyor PT. Carsurin 6. Spesifikasi 2 Terlampir 7. ‘Tangki penyimpanan 920-T-013 8. No. B/L 56106238086 9. ‘Volume (Bbis) 9) ank oket trl 10, Discrepancy terhadap aktual kirim : MT. LT (Liter) 920-T-013 7,019.747 6,909.104 51,163.79 8,130.270 8,266,586 *) Temp. ial) rs Temp. (Pas 316 *¢ MT 7,019.747 7,033.363 Quantity Discrapancy UNE B/L SFAL Quantity | RI (%) GOV (Liter) 8,266,586 8,288,031 KL@I5 8,130.270 LT 6,909.104 6,922.575 US Bbls 51,163.79 51,263.55 09.76] -0.19% e100) CA (Ceriiate Quanity Loaded) veslampic Dipindai dengan CamScanner?T. Trans-Pacific Petrochemical Indotama BERITA ACARA PENYERAHAN PRODUK OLEH PT. TPPI KEPADA PT. KPI DI KILANG TUBAN - JAWA TIMUR No.: TPPI/BAPP/VI.23/086 Hari /Tanggal : —Selasa, 20 Juni 2023 Tempat : Kilang TPPI Tuban Derikian berita Acara ini dibuat untuk dipergunakan sebagaimana mestinya ee mg A. PERTAMINA oS Pi INA 1. Adhita Setya Negara PT. KPI # Quantity Accounting Prremmadace™ 2. Hariadi Narhad PT. KPI Oil Movement B. TPPI 7 1. Ahmad Zunaidi Operation 2. Darsan Operation C. SURVEYOR 1. Fhilip Surindo $ PT. Carsurin Dipindai dengan CamScannerPropared by PT. TRANS PACIFIC PETROCHEMICAL INDOTAMA = | ‘LABORATORY OPERATION MANUAL Approved by : {A Certed 150 9001 Laboratory by TUVRnehind TPPI ‘Certicate No, 01 1001895122 wie RESULT OF ANALYSIS: Tasue Date PARAXYLENE tof eeree anit 48-Jun-23 ReportNo. _LAB-ROA-PX.28-221 Vessel Name MT. SUCCESS ENERGY XXXIL Date of sample received 18 June 2023 cargo PARA-XYLENE Time of sample received 9:00 Source $20-7-013 Date of sample tested 18 June 2023 5 Speciication , Propaites “| unit | Testmethos | | Result of Analysis 1 [Densiy@ 150. ~--. f= kan | astm a0s2 z 2 0.864 2 |Specific Gravity @60 °F 7 | astm 4052 0.864 0.866 0.865 Remark: This relates only to the sample tested and does not the bulk of material to be equality Witnessed by, PT Trans Pacific Petrochemical Indotama rteg bP PTLTRANS. PRI ROOT AR pang Shieh Sumas ‘Burin Laboratory Supervisor 9 Dipindai dengan CamScanner05, [= Doo: Na: PT. TRANS PACIFIC PETROCHEMICAL INDOTAMA ENG-1-ROA- |= — eet | LABORATORY OPERATION MANUAL Revision: A Certified 180 9001 Laboratory by TUVRheinland Cerificate No, 01 100 1835122 2ovJan-Z0 Page: RESULT OF ANALYSIS issue Date PARAXYLENE tof ts to onan 49-Jun-23, Report No. Vessel Name MT. SUCCESS ENERGY XXXII Date of sample received 19 June 2023 Cargo PARA-XYLENE Time of sample received 0:46 Source “SHORE PIPE LINE Date of sample tested 19 June 2023, ‘Specification ; No, Properties unit _[ Test ethos |] qa Result of Ants 1 |Specitic Gravity @60 °F - Jastup4os2] 0.264 0.866 0.865 2 [Density @ 18°C kgt | ASTM D 4052 - 0.8644 3 |Colour, PLCo Scale - [ASTM D 5386 : 10 1 4 Jostttonrange arenmnrg | age | astmoeso | - ‘| 2maeuewha | gy Remark: This relates only to the sample tested and does not the bulk of material to be equality, Witnessed by, PT Trans Pacific Petrochemical indotama PLTRANS PC ER Laboratory Supervisor SAL INDOTARAA ‘Sumadi 9 Dipindai dengan CamScannerPT. TRANS PACIFIC PETROCHEMICAL INDOTAMA. ENG--ROA- = rant LABORATORY OPERATION MANUAL : " ‘Approved By: cero aera Cue RESULT OF ANALYSIS: issue Date. ob 49Jun-23 ReportNo, _LAB-ROA-PX-23-223 VesselName MT, SUCCESS ENERGY XXXI! Date of sample received -19.June 2023 Cargo PARA-XYLENE Time of sample received 0:45 __ Source Date of sample tested 49 June 2023 No Properties unit | Test Method a | Result of Analysis 1 [Density @ t5°¢ kot | astm 4052 * : 0.8645 2 |Specinic Gravity @60 °F - | astwpaos2 | o8es | 0.866 088s | [3 |Colour, PtCoScale | - | astmossee| = - a) 4 Remark: This relates only to the sample tested and does not the bulk of material to be equality PT Trans Pacific Petrochemical Indotama PT TRANS PACH PEG OTA ‘Sumadi Laboratory Supervisor 9 Dipindai dengan CamScannerPT, TRANS PACIFIC PETROCHEMICAL INDOTAMA, Lssoraon oF Ma A Certified |SO 9001 Laboratory by TUVRheinland mn |FPP" cn eee Paci ‘CERTIFICATE OF QUALITY Tasve Date PARAXYLENE TS - PX. 0805 eee ReportNo, _LAB-COQ-PX.23.070 VesselName MT. SUCCESS ENERGY XXXII Date of sample received 18 June 2023 cargo PARA-XYLENE Time of sample received 9:00 Souree 920-7-018 Date of sample tested 18 June 2023 ‘Specification No, Properties + Unit | Test Method Result of Analysis i Tia JArpearance ce | ed redintaeeente | caeeere |e |Specific Gravity @60 °F >| ASTM 4052 0.864 0.866 0.865 Colour, Pt-Co Scale - ASTM D 5386, . 10 1 cia Wash Colour —_Pasmoes | 2 od Paraxylene (Purity) % wt UOP 720 99.7 = 99.9 INon-Aromatics % we UOP 720 - “02 ine Water oO (mm) JOll Height + 11332 (mm) ee rf cn PERS RHEE noon ax fe pies icteaee oe lit schichebestian Log Printed(3 (19/202 F2N596:45 PM WIS. Log Created : rsudarwanto 19 Jun 2023 23:35:39 Log Updated : 1968 8 Dipindai dengan CamScanner> TPPI PT. TRANS — PACIFIC PETROCHEMICAL INDOTAMA create Nasr wes Sycamore Mt, NOTICE OF DISCREPANCY To The Master of MT. SUCCESS ENERGY XXXII Date: 20-Jun-23 Berth Berth #5 Dear Sir, This is to bring your kind attention that the following discrepancy on the shipment of cargo in bulk at the present ascertained as follows; Grade of Cargo PARAXYLENE ASTM DISS Quantity ( Figure ) M3 @ 15°C Metric Tons Long Tons US Barrels Bill of Lading Figure 8,130.270 7,019,747 6,909.104 51,163.79 Ship Figure After Loading 8,146,123 7,033.363 6,922.575 51,263.55 Difference 15.853 13.616 13.471 99.762 Discrepancy % 0.19% 0.19% 0.19% 0.49 % Yours Faithfully MUHAMMAD Terminal Representat Acknowledged by, Master of Vessel ‘Surveyofirveyor:——_— For Receipt Only WhthoutpPrelutice (HASANUDDIN MT. SUCCESS ENERGY XXXII Dipindai dengan CamScannerNeer sm Sen ey ts ae a Me EE © TPPI PT, TRANS — PACIFIC PETROCHEMICAL INDOTAMA Facog: Soest NOSES Air ar Ie, won ULLAGE REPORT ‘AFTER LOADING MT SUCCESS ENERGY 0011 SOTA TPATUDAN Beth LORD 2s Banas 7 ou FTER LOADING es ot rr TR aay eR a TI commas | Tov TREO wor [tee [ram | mare | rscton | err, xs te F roe 88 ce o_o es_|asmoss| awe | ne ne mse = =e eu] ee on = = ca Tae | ee | oe 5 ‘zoe [esas | nt | 0 | Sz [-onsts | oseo01 | —erzs_| 2s | —esnso | paee | ssooo [ose [ener za [esas [nt |- 0 | “aoe Sts [-ooses | eseont | —etsasr [esa | seers | pees [sore | ose | ear 4363 _—| eso | wt | 0 | eae Sze[-ossts | eonart | —eonsse [e203 | —sesoet [ose [stent | osm [ess 57 | “eaten | 0 [oat ae 323 _|onses | -osezei | —eeaes [ez | aaza | ose | staaso | ose | er vai eras nt | 0 | rar S22 [uses —[-osezni_| —estass [e203 | ates ta | oes | senass [mma | s7taar zis | sogaae [na | oso 322 |- ons -osezet_| —avarar—[ e250 | ausnee | —oasce | sot07 | oma | sae aia | soa | nt] 0 | 05 s23_|- one oseant_| —sooam [60 | suxer | oes | sorare_| one | sano ao] —assazi—[ at] | sat aar[opss—[-eaean|—sras7 [200 | 213 | ome | 5300 [oxen [as asa | ssa | wt —| 0 | a0 ‘325 _| onses | oseast | —senapa [e200 | 210001 | —oatee [sonar aese | sna. ‘zs —| —asas7—| wt] 0 | 56657 Sir | webs | opeset | —sea7er | e203 | zanna —osace | a7 zs |osese_| —sot900 et —| —sstoz6 | wt | 0 —| sen Si7 | eases | oseont | sso 120 | 6200 a 223 | —sonnea | wt | 0 | —s65 00 Sea |oabis | -aseart | —sazoor | e200 | —2eana5 | ase —| sonz0e | osese_[ sin 19 7 Sea | oames_-oseari | —setrea [e200 | —zzvest | onese | sorair | oneu_[ siz] zt | —se5609 | wit | 0 | ss. a a zs_—| —se5950 | —wt—| 0 | ss 060 Szs—[ oasis | -asoost | —ereo [e200 | —z010e | noses | sore | omen_[—s0toe3 “zat | wore | wit | 0 | wor Sea [ oasis [-aseori | star —[ e203 | 20773 | nace | accor] ones yas | woe [we [ | oa Sis | ners | aseant | —siaroe [exes | —aerrst | —oneoe | —aoesra [one | sonar Toa = Ca a ae aaa Tae woerenoenr sunieveR 25 — ‘ra oAvAT FF CARGURD Dipindai dengan CamScanner© TPPI PT. TRANS — PACIFIC PETROCHEMICAL INDOTAMA, ead OMe: we: cine erate semen st SEL seta a oma ‘waar, MOONESIA.Phre 62395 O57, 1091-92 Fat: €258 4967, 6109, TANKER TIME SHEET VESSEL NAME: MT. SUCCESS ENERGY 0001 B/LNe, s0r05736008, FAG. NOONE Proouct PARARYLENE MASTER NAVE. CAPT. FASANUDOW. DESTINATION 7 CIWANDAN. NOONESA—————— CCONSIGNOR PT PERTAMINA PETROCHEWICAL TRADING, CCONSIGNEE = "TOTHE ORDER OF BANGKOK BANK PUBLIC COMPANY LIMES TROTICE OF READINESS TENOERED ANCHORAGE: FREE PRATIOUE GRANTED z = lorart(w) TF 120 Ta = ANCHOR AWE'GH Teen —| ot fears, TE PLOT BOARDED Ter mn 75 31381 FIRSTUNE ASHORE Tee [ALL MADE FAST [waTeR NOTICE OF READINESS ACCEPTED, INDEPENDENT SURVEYOR ON BOARD. KEY MEETING COMMENCED KEY MEETING COMPLETED TANS INSPECTION COMMENCED TANS INSPECTION COMPLETED HOSE CONNECTED ‘COUMENCED LOADING, [COMMENCED ONE FOOT SAMPLE COMPLETED ONE FOOT SAMPLE ora ner ‘SAMPLING ANALYZED PASSED (ONE FOOT) ig durna | — ose —[WETRIC TONE [RESUME LOADING 19D | 0100 tone Tons — [COWPLETED LOADING, Po.nur23 | 0139 —aaRRELB ATE [COMMENCED SAMELING [COWPLETED SAMPLING 'COWMENCED ULLAGING (COMPLETED ULLAGING Bw | 0500 {CARGO CALCULATION COMMENCED. Bin [0300 (CARGO CALCULATION COMPLETED wows —| 032 onary) [F830 Ta RECEIVED B/L FIGURE Doowwrzs | 0342 Baas 72500 HOSE DISCONNECTED IB | 000 nacen 75, 31351 Mt] [CARGO DOCUMENT ON BOARD. Dore 30 22497] PILOT BOARDED PIs lwareR 76 TUNGERTHED DnB [CARGO ON BOARS ToreaT_w] VESSEL SALED Due REMARKS: he 2023 af 05:38 LT up to 18 June 2023 t 2054 LT = Wang for MT. Somer 77 unborn — a 7 SETAE PLIES 288 gre POTENT hey Bey oe mga nae a : = - ae Dipindai dengan CamScanner