No.

Document : FRM-MILL-013
PT. CITRA RIAU SARANA Revisi : 01
FORMULIR
PCRS1 Tanggal Berlaku : 20 Juni 2019
Halaman : 1 dari 1
BERITA ACARA

No: ................../CRS-POM/KPM................../..................

Pada hari ini,......................tgl ................................ kami beritahukan Buah Afkir atau Mentah
hasil Sortasi TBS, ............................................... adalah sebagai berikut:

Fraksi O O = ............. Tandan = ......................

Kg
Fraksi O = ............. Tandan = ......................
Kg

JENIS POTONGAN
TBS Bermalam/Menginap = ............. % = ......................
Kg
Berondolan = ............. % = ......................
Kg
Sampah = ............. % = ......................
Kg
Air = ............. % = ......................
Kg
Tangkai Panjang = ............. Tandan = ......................
Kg
TOTAL POTONGAN = ................................
% = ......................
Kg

Jumlah = ................................
Kg
Total Potongan = ................................
Kg
Netto = ................................
Kg
Jumlah Tandan = ................................
Tandan
Jumlah Tandan dipulangkan = ................................
Tandan
Berat Rata-rata = ................................
Kg .................... BB/BS/BK......................
No. SPB = ................................
No. Polisi BK/BM/BA/B/....................

Desa Bumi Mulya, ...........................................

Pihak Pengirim, Bagian Sortasi, Pihak Penerima,

(............................) (...........................) (............................)