Consumable Request & Settlement Sheet (CRSS)

Request Date : 21 April 2023 Customer :

Sales Order No : Requester : Sibarani Andri Togap Maruli
Job Order No : ERF Number : ERF33939
Service Scope : Return Date :

Request (Permintaan) Settlement (Realisasi Penggunaan)

No Consumable Qty Used Balance Other Return To Sign (Tanda

(Jumlah) (Terpakai) (Sisa) (Dikembalikan tangan)
ke)

1 Sarung Tangan Bintik 2

2 Karung Sample 25 kg 15

3 Plastik Sample 25 kg 15

4 Pouchseal putih 15

5 Tali Rafia Bagong 1

Kecil

Remark:
ANGGARAKSA, BG. TANJUNG MEDANG 11, SAMPLER HERMAN

REQUEST APPROVAL
Requested by, Approved by, Approved by,

Sibarani Andri Togap Maruli Nataniel Adli Prasetyo

Requester BFO - General Affairs, Procurement & Head of Lab
Logistics

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