PROVISIONAL VERIFICATION REPORT (PVR)

(TO BE COMPLETED BY INSPECTOR) FM.OPSLSI.01.04,04 Rev.00

INSPECTION DATE : 15/03/2024 L/C NO. : VO NO. : MY11VE0050

EXPORTER : AJINOMOTO (MALAYSIA) BERHAD
DESCRIPTION OF GOODS : AS PER VO

INSPECTION LOCATION : No. 1 PERSIARAN TKNOLOGI 6, TECHPARK 2@ENSTEK, 71760, BANDAR ENSYEK, NEGERI SEMBILAN
CONTACT PERSON : Abby/MAHAZAN TELEPHONE NO : (03) 79806958
DISCREPANCY FOUND : SHIPPING MARKS :

CONTAINER NO. SIZE SEAL SHIPPERS SEAL WEIGHT PACKAGES

WT. DECLARED GROSS : 1,254.96 KG NETT : 1,200 KG COUNTRY OF ORIGIN

WT. CALCULATED GROSS : NETT : DECLARED MALAYSIA
MADE OF SHIPMENT : ON GOODS MALAYSIA
AIR OF SEA - FCL / LCL / CONV. / BULK SEA ON PACKING MALAYSIA
SAMPLING PLAN : RANDOM / VISUAL VISUAL QUALITY : NEW / USED / RECON NEW
PACKING DETAILS OF GOODS : PRODUCTION DATE :
EXPIRY DATE :
BATCH / LOT NO. :
M-UFX BLD 5kg X 4bag FINDINGS :
SATISFACTORY
ABORTED (REASONS)

CONDITIONAL
(SUBJECT TO)

TOTAL PACKAGES : 60 CTNS PENDING FOR :

PHOTOGRAPHS TAKEN AT SITE : YES NO CERT. OF ORIGIN

DOCUMENTS RECEIVED AT SITE : YES NO CERT. OF ANALYSIS
*SAMPLES TAKEN : (RETENTION/LAB TEST) YES NO OTHERS :

SURVEYOR NAME ACKNOWLEDGE RECEIPT :

NAME:

RAVIN

SIGNATURE SIGNATURE

NOTE : This report is valid for 30 days.

# Samples collected will be retained for 3 months (effective date of inspection). Exporters M U S T submit in writings for claiming of retained
samples after this period (minimum 2 weeks advance notice is required). All unclaimed samples will be disposed.