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BORDEN CO. (PTE.) LTD.

No. 9 Jalan Kilang, Singapore 159409 Form SMR.11.L

Appendix 1

Starting Materials Record


1. Date of receipt 2. Date of inspection 3. Standard name of material 4. Name of material on delivery note 5. Name and address of supplier 08 January 2013 Label 10 January 2013 English Text Label, USA, 24 ml, (LU4) EAGLE BRAND MEDICATED OIL BACK LABEL FORMULA LABEL : USA 24ML KOMARK - GENERAL LABELS & LABELLING PTE LTD Blk 164 Kallang Way #02-09/10 Kolam Ayer Industrial Park Singapore 349248 6. Country of origin of supplier 7. Suppliers batch/ Reference No. 8. Unit Identifying No. 9. Total quantity received 10. Number of packet(s) received 11. Number of packet(s) damaged
* Refer to Form CPM

Singapore 34786 / KM_LFYS_US_24

LU4-13-01 700,000 Pieces (14 Packets x 5 Rolls x 10,000 Pieces) 14 Packets (70 Rolls) NIL

12.1 DO No. & date 12.2 Purchase Order No. & date
Remarks:

95093KA dated 08-01-13 PO1212/028 dated 28/12/2012

The goods are inspected by Laboratory Technician with the assistance of the Storekeeper. Provide the Quarantine labels to the Storekeeper and instruct him to paste the labels on each packet.

Ref. SOP. NO. 107.8

Edition: 6

Date Effective: 01 June 2011

BORDEN CO. (PTE.) LTD.


No. 9 Jalan Kilang, Singapore 159409 Form SMR.11.L

Appendix 1

Starting Materials Record


Label
Instruct the Storekeeper to store the goods in the Quarantine Area. Choose 1 roll each from 3 packets, total 3 rolls, take 10 pieces from each roll, total 30 pieces, randomly, for further tests. Sample calculation: 0.4 x 70 = 3.35 3 rolls

PO quantity: PO Completed.

700,000 Pieces

DO quantity for this delivery: 700,000 Pieces Remaining balance after this delivery: NIL

Inspected By (Signature): Name : Ng Xue Li : : Quality Control Technician Quality Control Department

Designation Department Date

: Thursday, January 10, 2013

Description of item received Quarantine status label(s)

Quantity (Pieces) 14

Received by (Initial)

Date 10 January 2013

* Number of Quarantine labels printed: 15. Identical copy of Quarantine label is attached to this
document.

Ref. SOP. NO. 107.8

Edition: 6

Date Effective: 01 June 2011

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