Doc No.

Update
TSQ-LSP-QAF-09204/06/2014

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ID : 443/SPK/LSPro-Qualis/IV/2024
Company Name : PT. Distribusi Mebel Nusantara
Office Address : Jl. Jalur Sutera Boulevard No. 45, Kelurahan Kunciran, Kecamatan Pinang, Kota Tangerang, Provinsi Banten
15320
Factory Address : Nice Young Litech (Dong Guan) Co., Ltd.
Block 2#, Science Road 195#, Dongkeng Town, Dongguan, Guangdong, China
Responsible Company Name (import only) : PT. Distribusi Mebel Nusantara
Responsible Company Address (import only) : Jl. Jalur Sutera Boulevard No. 45, Kelurahan Kunciran, Kecamatan Pinang, Kota Tangerang, Provinsi Banten
15320
Number and date of assignment letter : -
Number and date of Sampling Officer assignment letter from Laboratory (if any) : -
Number and date of Sampling Report : 443/SPK/LSPro-Qualis/IV/2024, April 19th, 2024
Location of Sampling : Factory Market Port Others :
Certification Process : New Re-certification Surveillance Product Extension
Brand Extension Type Extension Re-sampling Others :
Certification System : System 5 √ System 1b Others :
Comodity : Portable Luminaries
Standard Number and Title : SNI IEC 60598-2-4:2012; Luminaires – Part 2: Particular requirements – Section 4: Portable general purpose
luminaires.
Sampling Method : Random Statistik
Sampling Date : April 26th, 2024
Name and Address of Sampling Locations : Nice Young Litech (Dong Guan) Co., Ltd.
Block 2#, Science Road 195#, Dongkeng Town, Dongguan, Guangdong, China

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 Doc No. Update
TSQ-LSP-QAF-09204/06/2014

Revision No page SAMPLING PLAN

00 2 of 2

Represent for Product Sample Total Test Archive

Sample Sample Sample Remarks
Brands Types (Art Name) Remarks Brands Types (Art Name) Remark (Pcs) (Pcs) (Pcs)

1 IKEA – IKEA –
SAMBORD floor/read
Portable SAMBORD floor/read lamp Max8.5W Portable Max8.5W 6 3 3 QI/443/01
lamp
Luminaires Luminaires

Sampling Officer, Lead Team/Management, Nice Young Litech (Dong Guan) Co., Ltd.

( THORIQ ASSHOLEH ) ( ) ( )

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