PT.

DWIPA KHARISMA MITRA

Kawasan Berikat Nusantara Jalan Medan Blok C3,
Marunda
Jakarta Utara - DKI Jakarta
Telp : (021) 44854918

EQUIPMENT INTERCHANGE RECEIPT

AND INSPECTION REPORT

NO : JKT.EIRIN.24.00000620
Date : 01 February 2024 19:35
Owner/Agent : FORECASTLE QQ.
JINJIANG SHIPPING
B/L Number : JJCSHJKY400054
Consignee : PT FAJAR BUANA
INTERNUSA TRANS
Trucking/Carrier : MIT
Vehicle Number : B9075JN
Ex. Vessel/Voy : ULSAN VOYAGER 2401N
Location :
Port Of Discharge: AIRIN
Place Of IC : Inward/Empty
Container No : BHCU3223676
Size : 20
Type : GP
Status : AV
DMF : 01/18
Mgw : 30480
Net : 2180
Grade :C
Remarks/Note
Received In Dirty Condition
Cleaning : Washing Water

Receiver :

Signature
Name :
Create/Printed By : WANTORO

FORM/DKMJKT/DEP/008