ffi$ffiw&

PPLi - Prasadha Pamunah Limbah lndustri

I ntegrated Enr;ironriental

Waste hlanagenrent Services ffi#

Form No. : 200-SC-F204

Plant Location & tt/ailing Adress

Jl.RayaNarogong-oe-saNamboP0'Box18-Cileungsi,Bogorl6S2a-lndonesia No sli[}870
Tel . : (62-21) 867 4A42 (Hunting) t (62 - 21) 567 3333
(Customer Service)
Siehes{ule No. ?3r210M
Fax. :ab - zl) 867 4043 E-mait : customerservice@ppli"co'id Sales Gder No ffi{tr001424

F (} R fvt TJ t ffi I.
g, B-3 L:
EJ kJ A N A F{ NGKUTAN f5
IA

( T r fr *i s p fi r + 8.& t g # p'i f{ e q u * s + fi # u r ) ," T

,.1
E,

IS SECTION MUS B E COMPLETED BY ORDER T.AKER)

ANG }IARUS DILEN GKAPI O{,EI{ FENERITV{A PES;{N {TEr
I
BAG Y

Pelaksanaan/Jam
Hari ini tgl 1?c11nA23 8:00:00AM
12t9n423 (Pick up date time) r gr. ]am
(Today's date)

fenis Truk,lContain€rr (Truck,/Container TyPe)

Nama : I
Drum Van
(Contact name) '
....9.*n:9.1........
RolI Off Truk
l/arL:
0lith /Withoilt Lift
Nama Perusahaan dan Alamat Open Box 10 Ms /22 L43 Sate)

16 M3 (Standard) CullWrg
Company Name €t Addres:-......... L6 M3 (Modit'y:higher /longer) Senii Truiler :

, ...... uH ILE-V. ER. ${noil E$tkLoclsrlc.......'..... Ta11k Seni'1i11:.ke1. : 261,'1i3 / j2 M3

:12M3/15M3/18M3 L)iltilt Trdilet / 10 Fcet / 20 [c.t
Sr:nti
. Kartasan..Brtt<it.lndah.Seldor.N. Blok.Nl Tank
Ro Cattpactor
Kelurahan RO VatttmTtnk
RO Oane
K' RO GullWing
Set Containcr : Iso Tattk/Opan Tapl'Dnt

OpmTop / CloseBorer 15, M3 : ....

Liqhl Truck

Pemintaan
(Request Order) S/O,P.U, DEL,W, LTL, D RS, P UP
Telepcp UL
0812-1321-0652 Requrst by Custofrer :
(Phone #)
A Label

l) >WfrDol

Penerima Pesan .. .NuilaYsni.Nasu[Pn. .. . .. .. l) Opm/CloseToPDrum

I lumboBag
(Order Taker) E others

|domol Profiie
|Jomor Marrifest

Rencana
ls111l3lr I imbah Yanq Di,rn;iut
'llnu/ll
,r{nrntk,T lai l,'., - i 1'1 1,"1" 1':'' ' Actual

,AN
G H A R tl 0 L E zu G F oL H PENGE U (r FI SECTION U ST BE G o M PL E TE BY DRIVER)
BA G IA N
CaLatan (Ttnrc Recortls)
Nama Pengemudi:
(Driaer Nnme)
V Dan fPLi
Tiba di
Custolfrer
PPrnuatan Dl Customer
\4r lai
Bernilgk7t Dari
Cilst'on1er
Tlbn
PPLi
Di lvnktil tetryuh

Nomor Truk {Truck No) tr 4 ?u

ffitt
Nomor ganddngan TemPelan 1[ull
Rincian Bar Rincran ........ Menit
(Bor (GooJ lletcnlion Time At CusioDrer .....-............................ ]a1n ................................

Dikirim Diambil
Lain-iain
Ii.oll of Box DrumType/Jenis
No. Bor Drum Metal/Plastic/Tutup Leba/Kecil Box.................................. .. ...... rn3
No.
10 m3 ( ..,.......) 200 Ltr :....................... ...
Bug...... ............. " "'rn3
12 m3 ( .
........ ...) 150 ltr :.........................i Drum Metal/Ptastic/Tutup Lebar/Kecil

Karet m3 ........) 100 Ltri.............................Drum Metal/Plastic/TutuP Lebd/Kecii lerigen/Pail................ ... ...... Liter

.. m3 Other r.............,.........,..... Drm I-ebar/Keci) Jumlah................................

Bolt Screw
Comment From Customer:

Remarks/Keterangan : (Diisi oteh Driver atau CSO)

Punuakarta. Jawa Barat. l/\hste - kontainer akan lirnbah

Cttstotner O.fJicet

Nasution
)( (...".....".... (...".""... )

Catatan Recoi'd)

Klometet A?Jir f Kiloue t er en d IankTNpt[\/ Distailce

Kjlonetet Awalf Kilofretet Start