BORDEN CO. (PTE.) LTD.

Appendix 1

No. 9 Jalan Kilang, Singapore 159409

Form SMR.10.L

Starting Materials Record

1. Date of receipt:

Label
08 March 2011

2. Date of Inspection

09 March 2011

3. Standard name of material

English Text Label, Thailand, 12 ml, (LV1)

4. Name of material on delivery

FORMULA (BACK) LABEL THAILAND - 12ML

note
5. Name and address of

6. Country of origin of supplier

KOMARK General Labels & Labeling Pte. Ltd.

Blk 164 Kallang Way #02-09/10
Kolam Ayer Industrial Park
Singapore 349248
Singapore

7. Suppliers Batch/ Reference

KM_LFYS_THAI_12

No.
8. Unit Identifying No.:

LT1-11-01

supplier

9. Total Quantity Received

90,000 Pieces
(1 Packet x 9 Rolls x 10,000 Pieces)

10. Number of Packets

1 Packets
(9 Rolls)

Received
11. Number of Packets

NIL

Damaged
12.1 DO No. & date
89162KA dated 08-03-11
12.2 Purchase Order No. & date PO1103/002 dated 01-03-2011
13. Remarks:
13.1 The Goods are inspected by Laboratory Technician with the assistance of
the Storekeeper.
13.2 Provide the Quarantine status labels to the Storekeeper and instruct him
to paste the labels on each packet.
13.3 Instruct the Storekeeper to store the goods in the Quarantine Area.
13.4 Choose 1 roll from 1 packet, total 1 roll, take 10 pieces, total 10 pieces,
randomly, for further tests.
Sample Calculation: 0.4 x 9 = 1.2 1 rolls
PO quantity:
90,000 Pieces
DO quantity for this delivery:
90,000
PO completed.
Pieces
Remaining balance after this delivery:
NIL
Inspected By (Signature):
Name:
William Chandra
Designation: Quality Control Technician
Department: Quality Control Department
Ref. SOP. NO. 107.6
December 2010

Edition: 4

Date Effective: 01

BORDEN CO. (PTE.) LTD.

Appendix 1

No. 9 Jalan Kilang, Singapore 159409

Form SMR.10.L

Starting Materials Record

Date:

Label

Wednesday, March 09, 2011

Description of Item
Received
Quarantine status label

Quantity
(Pieces)
1

Received by
(Initial)

Date
09 March 2011

* Identical copy of Quarantine status label provided to the storekeeper is attached to this
document.

Ref. SOP. NO. 107.6

December 2010

Edition: 4

Date Effective: 01