GOVERNMENT OF EAST JAVA PROVINCE

INVESTMENT BOARD
UPT INTEGRATED LICENSE SERVICE
JI. Pahlawan No.116 Telp. (031) 3577691- 3577692 Fax (0313577693)
Website:http://p2t.iati mprov.go.id
Email: p2t@jatimprov.go.id
S U R A B A Y A 60174

GROUND WATER USAGE PERMIT (GWUP OF EXPLOITATION)

THE FIFTH BORE WELL (FIVE)
NUMBER: P2T/257/15.09/01/VI/2016

Considering: 1. Letter dated 20 April of 2016 Number: 048/LEG – SRT/AWI/IV/2016

concerning: Ground Water Exploitation Permit (SIPA) of the Fifth Bore Well (five)
on behalf TH. M. Wisnu Adjie as a Director of PT Akasha Wira International Tbk.

2. Minutes of Field Survey dated - N umber: -

3. Technical recommendation on Ground Water Usage Permit of the New Bore Well
dated 6 June of 2016 Number: ESDM/ 1180/119.4/AT/2016 from Head of
Energy and Mineral Resources Office of East Java Province.

Granting the permit to

Name of Applicant : TH. M. Wisnu Adjie
Title : Director
Address : Jl. Wirajasa Terusan No. 5 RT.001 RW. 008 Cipinang
Melayu, East Jakarta

Name of Company : PT AKASHA WIRA INTERNASIONAL, Tbk

Status of Company : Domestic Investment
Address : Jl. Raya Surabaya – Malang Km. 59 Sengonagung village,
Purwosari, District of Pasuruan
Phone No./Fax : Phone 0343-611075-77
Fax. 0343-611078

Well location : Sengonagung village, Purwosari, District of Pasuruan

Well coordinate : LS - 07°, 15°, 23,9” BT = 112°, 43’, 11,0”
Type of activity/business : Industry
Ground water allotment : Package Drinking Water Industry

DETERMINED TECHNICAL SPECIFICATION

Number of Registration : 35.14.08.24
Well Depth : 102 meter
Well Diameter : O-inch
Allowed usage flow : 1,353 (one thousand three hundred fifty three) m3/day

Piping Construction
Depth of Incised Pipe : 60 m.bmt until 90 m.bmt
- Jambang Pipe : O 8 inch; length 54 meter
Sirainer : O – inch; length - meter
Sirainer position : O – meter until – meter. bmt

- Pipe Up : O 6 inch; length 21 meter

Sirainer : O 6 inch; length 27 meter
Sirainer position : 60 m.bmt until 75 m.bmt; 78 m.bmt until 90 m.bmt

- Total of Sirainer : 27 meter.bmt

Type of Pump : Submersible
Pump Capacity : 15 KW
Pump position : 54 meter bmt
Suction pipe diameter : 0 2,5 inch; length 54 meter.bmt
Validity of permit : 3 (three) year since issued date

Issued in Surabaya
Dated: 7 June 2016

Carbon Copies Notation:

1. Mr. Head of Energy & Mineral

Resource of East Java
Province of Surabaya
2. Mr. Regent of Pasuruan, East Java
 RIGHTS, OBLIGATION AND SANCTION
Rights:
Obtaining and using the ground water according
to determined flow and allotment.
Obligation:
a. Paying tax of ground water usage in
accordance with the provision of prevailing
laws.
b. Installing water meter in which have
conducted calibration and sealed by
authorized institution and placed above
ground surface and be equipped with
security housing of water meter at least
within of 1 (one) month after issued permit.
c. Making a rainwater infiltration well
according to applied technical specification
at least prior to the end of period of SIPA.
d. Using the ground water not exceed allowed
maximum flow according to the provision of
SIPA and does not change technical data.
e. Responsible to all causes that can harm
other party due to ground water usage
activity.
f. Reporting the amount of ground water
usage once in every month to Energy and
Mineral Resource Office of East Java
Province.
g. Reporting the analysis result of physical and
chemical laboratory test of ground water
once in every year to Energy and Mineral
Resource Office of East Java Province.
h. Maintain the environmental preservation
and the potential of ground water resources.
i. Making 1 (one) surveillance well that be
equipped with AWLR telemetric GSM in the
event there are 5 (five) of bore well or more
within area less than 10 (ten) hectare.
j. Revise Environmental Impact Assessment
Document (AMDAL) together with hydrology
review of ground water in the event carry out
ground water usage exceed 50 liter/second
every 1 (one) of bore well.
k. Reporting in the event damages of water
meter and water meter security seal to
Energy and Mineral Resources Office of East
Java Province.
l. Submit proposal of the extension in writing
to Governor of East Java through Head of
Integral License Services of East Java
Province prior to 3 (three) month of the end
limit of period of SIPA.
m. Granting maximum of 10 (ten) percent of
allowed flow maximum limit within SIPA to
surrounding community in the event need of
ground water.
n. Submit proposal of ownership letter of
surveillance well to Energy and Mineral
Resources Office of East Java Province, in
the event have surveillance well be equipped
with Automatic Water Level Recorder
(AWLR) telemetric GSM.
Sanction
Administrative sanction in the form
written warning imposed to SIPA
holder, if:
a. Does not report the amount of ground
water usage once in every month to Energy
and Mineral resources Office of East Java
Province.
b. Does not report analysis result of physical
and chemical laboratory test of ground
water once in every year to Energy and
Mineral resources Office of East Java
Province.
c. Does not make infiltration well surrounded
company location.
d. Does not report the recorder data of
surveillance well once in every month to
Energy and Mineral Resources Office of
East Java Province, in the event had have
the ownership letter of surveillance well
Administrative sanction in the form
sealed temporary closing imposed to
SIPA holder, if:
a. Carry out action that can causes damage
of water meter and water meter security
seal.
b. Does not install water meter have
conducted calibration and sealed by
authorized institution at least within 1
(one) month after issued date.
Administrative sanction in the form
permit revocation imposed to SIPA
holder, if:
a. Does not paying tax of ground water usage
according to the provision of prevailing
laws.
b. Change or replace the specific tools so as
not appropriate with technical
specification stipulated within the permit.
Criminal sanction imposed to SIPA
holder, if:
a. Conduct breach to the provision of Article
33 of Regional Regulation of East Java
Province Number 12 of 2011 concerning
Ground water management threatened
with imprisonment of a maximum of 6
(six) months or a maximum fine of
50,000,000 (Fifty Million Rupiah)
b. In the event that the criminal act carried
out is threatened with a crime higher than
the criminal threat in this Regional
Regulation, a higher threat is imposed
o. Reporting recorder data of surveillance well
once in every month to Energy and Mineral
Resource Office, in the event have ownership
letter of surveillance well.