BERITA ACARA

COAL MINING
PERIODE 1 JANUARI - 31 JANUARI 2022

PT. ANUGERAH COVINDO INDONESIA

SITE GPU 1 BLOCK SOUTH 1
 BERITA ACARA JOINT SURVEY OB REMOVAL PIT GPU 1 - BLOCK SOUTH
No 04/BA-JS/ACI-GPU/I/2022

Pada hari ini, Sabtu tanggal 5 Febuari 2022 telah disepakati bersama hasil joint Survey periode 1 - 31 Januari 2022.
periode pengukuran tanggal 1 Januari 2022 antara PT. Gorby Putra Utama dengan PT. Anugerah Covindo Indonesia
dengan rincian sebagai berikut :
PIT GPU 1 BLOCK SOUTH 1

Overburden (OB)
Total Mining Boundary 103,800.34 M²
Total Volume Top Soil Joint Survey 1 s/d 31 Januari 2022 5,401.11 BCM
Total Volume OB Joint Survey 1 s/d 31 Januari 2022 300,836.27 BCM
Total Volume Coal Joint Survey 1 s/d 31 Januari 2022 21,341.07 BCM

Total Claim Volume Overburden 1 s/d 31 Januari 2022 306,237.379 BCM

Demikian Berita Acara ini dibuat untuk dapat di pergunakan sebagai mestinya

Beringin Makmur, 6 Februari 2022

Prepared by
PT. Anugerah Covindo Indonesia

Roni Rustana B. Jonckgi Brillianto Heri Purwanto

Sr. Surveyor ACI Engineering ACI Project Manager ACI

Approve by
PT. Gorby Putra Utama

Zainal Abidin Ananto Setyo Adi Ferry Juanda

Surveyor GPU Engineering GPU KTT GPU
 BERITA ACARA PENGUKURAN JARAK OB PT. ACI
No 04/BA-JS/ACI-GPU/I/2022

Pada hari ini, Sabtu 5 Febuari 2022, telah disepakati bersama hasil pengukuran jarak Periode 1 s/d 31 Januari 2022 antara
PT Anugerah Covindo Indonesia dengan PT. Gorby Putra Utama meliputi :

Average Jarak Overburden dari front ke disposal 692.570 M

Jika Actual Jarak overburden kurang dari kesepakatan pada kontrak, maka akan di bebankan pada bulan selanjutnya

Demikian Berita Acara ini agar dapat dipergunakan sebagai mestinya.

Beringin Makmur, 6 Februari 2022

Prepared by
PT. Anugerah Covindo Indonesia

Roni Rustana B. Jonckgi Brillianto Heri Purwanto

Sr. Surveyor ACI Engineering ACI Project Manager ACI

Approve by
PT. Anugerah Covindo Indonesia

Zainal Abidin Ananto Setyo Adi Ferry Juanda

Surveyor GPU Engineering GPU KTT GPU
 BERITA ACARA PENGUKURAN JARAK COAL HAULING PT. ACI
No 03/BA-JS/ACI-GPU/I/2022

Pada hari ini, Sabtu 5 Febuari 2022, telah disepakati bersama hasil pengukuran jarak Periode 01 s/d 31 Januari 2021
antara PT Anugerah Covindo Indonesia dengan PT. Gorby Putra Utama meliputi :

Jarak Coal Getting dari front Pit 1 ke CPP : 3,928.34 Vol 27,409.046 MT

Demikian Berita Acara ini agar dapat dipergunakan sebagai mestinya.

Beringin Makmur, 6 Februari 2022

Prepared by
PT. Anugerah Covindo Indonesia

Roni Rustana B. Jonckgi Brillianto Heri Purwanto

Sr. Surveyor ACI Engineering ACI Project Manager

Approve by
PT. Gorby Putra Utama

Zainal Abidin Ananto Setyo Adi Ferry Juanda

Surveyor GPU Engineering GPU KTT GPU
 BERITA ACARA COAL MINING & COAL HAULING PERIODE DESEMBER 2021 PT. ACI
No 03/BA-JS/ACI-GPU/I/2022

Pada hari ini, Sabtu 5 Febuari 2022, telah diadakan rekonsiliasi Coal Getting dan Coal Hauling Periode 1 s/d 31 Januari 2021
2021 antara PT. Anugerah Covindo Indonesia dengan PT. Gorby Putra Utama meliputi :

Peralatan muat menggunakan :

a. Berita Acara Coal Mining
No Unit Ton
1 SY500 27,409.046

Peralatan Hauler menggunakan :

B. Berita Acara Coal Hauling From PIT to CCP
No Unit Ton
1 FM270 27,409.046

Dengan rincian sebagai berikut :

Rincian A:
DAY NIGHT
No. Tanggal Tonage Tonage Total Tonage
1 1-Dec-21 - - -
2 2-Dec-21 - - -
3 3-Dec-21 - - -
4 4-Dec-21 - - -
5 5-Dec-21 1,117.36 - 1,117.36
6 6-Dec-21 - 1,077.95 1,077.95
7 7-Dec-21 1,140.83 1,075.87 2,216.70
8 8-Dec-21 1,223.16 1,146.54 2,369.70
9 9-Dec-21 - - -
10 10-Dec-21 - - -
11 11-Dec-21 - - -
12 12-Dec-21 1,122.82 1,100.47 2,223.28
13 13-Dec-21 1,066.87 864.30 1,931.17
14 14-Dec-21 1,110.92 746.62 1,857.53
15 15-Dec-21 1,008.35 - 1,008.351
16 16-Dec-21 785.21 - 785.207
17 17-Dec-21 - 517.30 517.300
18 18-Dec-21 549.31 550.37 1,099.680
19 19-Dec-21 - - -
20 20-Dec-21 559.53 587.42 1,146.950
21 21-Dec-21 - - -
22 22-Dec-21 - - -
23 23-Dec-21 535.04 - 535.043
24 24-Dec-21 664.63 683.75 1,348.379
25 25-Dec-21 - - -
26 26-Dec-21 565.50 628.68 1,194.179
27 27-Dec-21 658.48 508.27 1,166.749
28 28-Dec-21 1,267.77 339.45 1,607.214
29 29-Dec-21 1,276.54 - 1,276.540
29 30-Dec-21 1,091.20 1,365.73 2,456.926
30 31-Dec-21 - 472.84 472.840
27,409.046

No Unit Tonage
1 XEXSY500014 3,441.941
2 XEXSY500015 7,305.127
3 XEXSY500016 8,922.023
4 XEXSY500017 4,503.185
5 XEXSY500018 3,236.770
27,409.046
Rincian B:
TANGGAL DAY (TON) NIGTH (TON) HAULER
TOTAL
ALL UNIT
1-Dec-21 - - HINO FM270 -
2-Dec-21 - - HINO FM270 -
3-Dec-21 - - HINO FM270 -
4-Dec-21 - - HINO FM270 -
5-Dec-21 1,117.36 - HINO FM270 1,117.36
6-Dec-21 - 1,077.95 HINO FM270 1,077.95
7-Dec-21 1,140.83 1,075.87 HINO FM270 2,216.70
8-Dec-21 1,223.16 1,146.54 HINO FM270 2,369.70
9-Dec-21 - - HINO FM270 -
10-Dec-21 - - HINO FM270 -
11-Dec-21 - - HINO FM270 -
12-Dec-21 1,122.82 1,100.47 HINO FM270 2,223.28
13-Dec-21 1,066.87 864.30 HINO FM270 1,931.17
14-Dec-21 1,110.92 746.62 HINO FM270 1,857.53
15-Dec-21 1,008.351 - HINO FM270 1,008.351
16-Dec-21 785.207 - HINO FM270 785.207
17-Dec-21 - 517.300 HINO FM270 517.300
18-Dec-21 549.310 550.370 HINO FM270 1,099.680
19-Dec-21 - - HINO FM270 -
20-Dec-21 559.530 587.420 HINO FM270 1,146.950
21-Dec-21 - - HINO FM270 -
22-Dec-21 - - HINO FM270 -
23-Dec-21 535.043 - HINO FM270 535.043
24-Dec-21 664.629 683.750 HINO FM270 1,348.379
25-Dec-21 - - HINO FM270 -
26-Dec-21 565.500 628.679 HINO FM270 1,194.179
27-Dec-21 658.48 508.27 HINO FM270 1,166.75
28-Dec-21 1,267.77 339.45 HINO FM270 1,607.21
29-Dec-21 1,276.54 - HINO FM270 1,276.54
30-Dec-21 1,091.20 1,365.73 HINO FM270 2,456.93
31-Dec-21 - 472.84 HINO FM270 472.84
27,409.046

Beringin Makmur, 6 Februari 2022

Prepared by
PT. Anugerah Covindo Indonesia

Roni Rustana B. Jonckgi Brillianto

Sr. Surveyor ACI Engineering ACI

Approve by
PT. Gorby Putra Utama

Zainal Abidin Ananto Setyo Adi

Surveyor GPU Engineering GPU
 PT. ANUGERAH COVINDO INDONESIA
MINE OPERATION: PT GORBY PUTRA UTAMA
SOUTH SUMATRA

No :
Subject : Certificate of Work Progress Join Survey EOM Januari 2022
Attachment : Inpit OB Removal Calculation

PERIODE : 1/01/2022 - 31/01/2022

MONTH : End of Month Januari 2022

PROJECT : PT. Gorby Putra Utama

1 Inpit Volume
1.1 Inpit Removal Volume A 332,455.655 bcm
1.2 Coal Removal Volume B 21,746.646 bcm
1.3 Overcut of Boundary Design Volume C 268.060 bcm
1.4 Pending Volume D 4,203.570 bcm
1.5 Top Soil removal Volume E 5,401.106 bcm
1.6 Mud removal Volume F - bcm
Inpit OB Removal Volume G=A-B-C-D+E 306,237.379 bcm

TOTAL OB & TOPSOIL Join Survey H=G 306,237.379 bcm

OB Distance 692.570 m

Beringin Makmur, 6 Februari 2022

Prepared By Approved By
PT Anugerah Covindo Indonesia PT. Gorby Putra Utama

Roni Rustana Zainal Abidin

Sr. Surveyor Mine Surveyor
Date: 6 Februari 2022 Date: 6 Februari 2022

`
 PT. ANUGERAH COVINDO INDONESIA
MINE OPERATION: PT GORBY PUTRA UTAMA
SOUTH SUMATRA

INPIT OVERBURDEN REMOVAL ORIGINAL TO SURFACE

Owner : PT. Gorby Putra Utama Year : 2022

Location : PIT GPU 1 - Block South Progress : EoM Januari

Date Of Joint Survey : 1 Februari 2022

Instrument : Leica TS 06 Flexiline
Software : Surpac 6.3.2
Top DTM : orig_0122_29up_pit_gpu1.dtm
Bottom DTM : prog_eom_0222_01_pit_gpu1.dtm
Design : pit_gpu_2021.str

NO DESCRIPTION QUANTITY ( BCM ) QUANTITY ( TON ) REMARK

I * OB Removal
* Void Desember A 530,840.595
* Cutting Out EoM January B 870,090.030
* Fill C 6,793.780
* Void EoM January D=B-C 863,296.250
* Material Removal E=D-A 332,455.655
* Mud Removal F -
* Topsoil Removal G 5,401.106
* Volume Of Coal H 21,746.646 27,409.046
* S40U_1 F1 10,322.509 12,965.071
* S40U_2 F2 2,190.227 2,750.925
* S40L_1 F3 8,056.174 10,174.948
* S40L_2 F4 1,177.736 1,518.102
* Pending Volume I 4,203.570
* Overcut of Boundary Design J 268.060
* OB Removal Non Topsoil January K=E-G-H-I-J 300,836.273

Beringin Makmur, 6 Februari 2022

Prepared by, Approved by,

PT. Anugerah Covindo Indonesia PT. Gorby Putra Utama

Roni Rustana Zainal Abidin

Sr. Surveyor Mine Surveyor
Date: 6 Februari 2022 Date: 6 Februari 2022
 Haul Distance OB
Jan-22
Volume Overburden (bcm) Haul Distance (meter)

Waste (bcm)- Waste (bcm)- Waste (bcm)- Waste (bcm)-

Date Waste (bcm)-XEXSY500014 XEXSY500014 XEXSY500015 XEXSY500016 XEXSY500017 XEXSY500018
XEXSY500015 XEXSY500016 XEXSY500017 XEXSY500018

DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS
01-Jan-22
02-Jan-22 1,600.00 464.00 832.00 352.00 1,456.00 677.82 585.55 585.55 647.46 647.46
03-Jan-22 2,944.00 16.00 1,952.00 1,472.00 1,472.00 583.79 648.98 553.20 553.20 653.55
04-Jan-22 2,304.00 2,368.00 896.00 2,704.00 1,744.00 2,384.00 617.73 617.73 692.62 692.62 726.35 726.35
05-Jan-22 2,640.00 1,968.00 2,352.00 1,408.00 621.69 647.31 600.49 716.75
06-Jan-22 1,904.00 1,656.00 1,968.00 672.01 744.95 800.00
07-Jan-22 1,448.00 1,680.00 590.70 2,531.75 2,522.00 1,708.85 2,192.00 630.90 630.90 709.50 697.95 697.95 767.05 767.05
08-Jan-22 1,728.50 1,600.00 2,504.50 2,856.00 2,788.95 1,664.00 726.81 726.81 676.07 676.07 771.50 771.50
09-Jan-22 2,616.00 3,216.00 637.52 754.52
10-Jan-22 1,168.00 1,392.00 1,216.37 1,152.00 1,967.00 2,672.00 651.92 651.92 731.49 731.49 800.89 800.89
11-Jan-22 2,832.00 2,920.00 1,088.00 8,856.00 705.46 705.46 824.10 824.10
12-Jan-22 2,592.00 2,288.00 2,144.00 2,608.00 2,736.00 2,592.00 717.30 717.30 724.42 724.42 820.42 820.42
13-Jan-22 2,560.00 1,760.00 3,056.00 2,960.00 2,528.00 2,800.00 650.74 650.74 683.77 683.77 815.68 815.68
14-Jan-22 2,832.00 3,008.00 2,464.00 2,976.00 2,656.00 3,376.00 686.98 686.98 762.95 762.95 873.24 873.24
15-Jan-22 2,912.00 3,008.00 3,088.00 3,216.00 628.00 628.00 712.41 712.41
16-Jan-22 1,056.00 3,456.00 2,768.00 2,096.00 3,328.00 2,784.00 678.75 678.75 584.42 584.42 708.44 708.44
17-Jan-22 2,608.00 752.00 2,064.00 2,208.00 3,616.00 662.77 662.77 716.00 747.55 747.55
18-Jan-22 2,976.00 2,272.00 2,812.00 749.02 749.02 740.82
19-Jan-22
20-Jan-22 1,904.00 1,328.00 1,992.00 1,744.00 1,264.00 2,464.00 669.59 669.59 603.40 603.40 758.77 758.77
21-Jan-22 2,032.00 96.00 2,666.00 240.00 2,448.00 336.00 788.77 788.77 789.53 789.53 557.13 557.13
22-Jan-22
23-Jan-22 880.00 3,040.00 1,184.00 1,520.00 1,888.00 438.14 652.70 652.70 641.89 438.14
24-Jan-22 2,536.00 1,040.00 1,264.00 1,990.00 2,358.00 960.00 652.69 652.69 641.89 641.89 898.68 898.68
25-Jan-22
26-Jan-22 1,056.00 2,048.00 3,600.00 3,136.00 781.39 781.39 704.54 704.54
27-Jan-22 2,064.00 2,624.00 2,144.00 3,068.00 2,640.00 2,672.00 805.91 805.91 632.76 632.76 524.47 524.47
28-Jan-22 2,128.00 2,544.00 1,984.00 2,784.00 1,984.00 2,496.00 750.00 750.00 746.91 746.91 515.07 515.07
29-Jan-22 3,632.00 1,744.00 2,368.00 4,208.00 1,408.00 2,720.00 754.00 754.00 773.66 773.66 524.47 524.47
30-Jan-22 2,668.66 2,336.00 2,736.00 3,360.00 2,528.00 1,868.10 674.28 674.28 773.66 773.66 524.47 524.47
31-Jan-22 2,272.00 2,256.00 3,264.00 670.63 648.40 599.82

Total 4,944.00 3,968.00 31,288.50 27,200.00 33,717.36 29,940.00 37,336.62 46,824.00 35,958.80 55,060.10 619.71 647.78 673.86 698.90 691.26 687.73 686.02 683.99 720.25 702.66

Beringin Makmur, 6 Februari 2022

Prepared by
Summary PT. Anugerah Covindo Indonesia
Unit
Dist (M) Vol
OB
XEXSY500014 633.743 8,912.000
XEXSY500015 686.378 58,488.500
XEXSY500016 689.497 63,657.360
XEXSY500017 685.003 84,160.620 Roni Rustana B. Jonckgi Brillianto
XEXSY500018 711.456 91,018.899 Sr. Surveyor ACI Engineering ACI
Total Volume 306,237.379 BCM
Weight Average Dist 692.570 M

Approve by
PT. Gorby Putra Utama

Zainal Abidin Anantyo Setyo Adi

Surveyor GPU Engineering GPU
 Haul Distance Mud
Nov-21
Production by Survey Haul Distance (meter)
Waste (bcm)- Waste (bcm)- Waste (bcm)- Waste (bcm)- Waste (bcm)-
Date XEXSY500014 XEXSY500015 XEXSY500016 XEXSY500017 XEXSY500018
XEXSY500014 XEXSY500015 XEXSY500016 XEXSY500017 XEXSY500018
DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS
01-Nov-21 - - - - - - - - - -
02-Nov-21 - - - - - - - - - -
03-Nov-21 - - - - - - - - - -
04-Nov-21 - - - - - - - - - -
05-Nov-21 - - - - - - - - - -
06-Nov-21 536.800 308.000 299.200 448.800 325.600 594.727 - 583.895 583.895 603.297 603.297 - - - -
07-Nov-21 774.000 1,091.200 950.400 - - - - - - - - - -
08-Nov-21 176.000 - - - - - - - - - -
09-Nov-21 871.000 - - - - - - - - - -
10-Nov-21 - - - - - - - - - -
11-Nov-21 - - - - - - - - - -
12-Nov-21 - - - - - - - - - -
13-Nov-21 228.800 - - - - - - - - - -
14-Nov-21 - - - - - - - - - -
15-Nov-21 - - - - - - - - - -
16-Nov-21 516.924 - - - - - - - - 453.576 -
17-Nov-21 1,047.200 - - - - - - - - - -
18-Nov-21 704.000 1,029.600 - - - - - - - - - -
19-Nov-21 - - - - - - - - 388.749
20-Nov-21 26.400 686.400 - - - - 389.945 396.523 - - - -
21-Nov-21 35.200 - - - - - - - -
22-Nov-21 - 1,469.600 695.200 1,330.777 - - - - 403.746 356.812 - - - -
23-Nov-21 - 396.000 382.155 - - - - - - 355.869 - - -
24-Nov-21 8.800 - - - - - - - - - -
25-Nov-21 - - - - - - - - - -
26-Nov-21 237.600 - - - - - - 425.834 - - -
27-Nov-21 724.664 - 407.734 - - - - - - - -
28-Nov-21 - - - - - - - - - -
29-Nov-21 - - - - - - - - - -
30-Nov-21 - - - - - - - - - -

Total 3,836.988 1,469.600 1,795.200 299.200 3,036.000 1,656.377 382.155 - 2,138.400 686.400 594.727 407.734 583.895 583.895 465.663 452.211 390.852 - 421.163 -

Beringin Makmur, 6 Februari 2022

Summary
Unit Prepared by
Dist (M) Vol
OB PT. Anugerah Covindo Indonesia
XEXSY500014 501.231 5,306.588
XEXSY500015 583.895 2,094.400
XEXSY500016 458.937 4,692.377
XEXSY500017 390.852 382.155 Roni Rustana B. Jonckgi Brillianto
XEXSY500018 421.163 2,824.800 Sr. Surveyor ACI Engineering ACI
Total Volume 15,300.320 BCM
Weight Average Dist 482.036 M

Approve by
PT. Gorby Putra Utama

Hangger Aqiim M.P Anantyo Setyo Adi

Surveyor GPU Engineering GPU
 Haul Distance Coal
Jan-22
Volume Coal (Ton) Haul Distance Coal (meter)

Date XEXSY500014 XEXSY500015 XEXSY500016 XEXSY500017 XEXSY500018 XEXSY500014 XEXSY500015 XEXSY500016 XEXSY500017 XEXSY500018

DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS DS NS
01-Jan-22
02-Jan-22
03-Jan-22
04-Jan-22
05-Jan-22 1,117.360 4,016.717
06-Jan-22 1,077.951 4,034.721
07-Jan-22 1,140.830 1,075.87 3,954.132 3,954.132
08-Jan-22 1,223.160 1,146.536 3,851.968 3,851.968
09-Jan-22
10-Jan-22
11-Jan-22
12-Jan-22 1,122.816 1,100.466 3,939.130 3,939.130
13-Jan-22 1,066.866 864.301 3,854.137 3,854.137
14-Jan-22 1,110.916 746.615 3,905.859 3,905.859
15-Jan-22 1,008.351 3,907.227
16-Jan-22 785.207 3,903.113
17-Jan-22 517.300 3,903.113
18-Jan-22 549.310 550.370 3,930.743 3,930.743
19-Jan-22
20-Jan-22 559.530 587.420 3,979.213 3,979.213
21-Jan-22
22-Jan-22
23-Jan-22 535.043 3,979.213
24-Jan-22 664.629 683.750 3,979.213 3,979.213
25-Jan-22
26-Jan-22 565.500 628.679 3,937.563 3,937.563
27-Jan-22 658.480 508.269 3,932.670 3,932.670
28-Jan-22 - - 1,267.766 339.448 3,999.115 3,999.115
29-Jan-22 - - 1,276.540 3,895.409
30-Jan-22 - - 1,091.200 1,365.726 3,840.837 3,840.837
31-Jan-22 - - 472.840 3,840.837

Total 2,363.990 1,077.951 4,155.185 3,149.942 5,088.701 3,833.322 3,026.790 1,476.396 1,108.840 2,127.930 3,903.050 4,034.721 3,913.647 3,919.727 3,917.411 3,891.524 3,962.140 3,956.449 3,954.978 3,913.477

Summary Beringin Makmur, 6 Februari 2022

Unit Prepared by
Dist (M) Vol
OB PT. Anugerah Covindo Indonesia
XEXSY500014 3,968.886 3,441.941 `
XEXSY500015 3,916.687 7,305.127
XEXSY500016 3,904.467 8,922.023
XEXSY500017 3,959.295 4,503.185
XEXSY500018 3,934.227 3,236.770
Total Volume 27,409.046 Ton
Weight Average Dist 3,928.336 M Roni Rustana B. Jonckgi Brillianto
Sr. Surveyor ACI Engineering ACI

Approve by
PT. Gorby Putra Utama

Zainal Abidin Anantyo Setyo Adi

Surveyor GPU Engineering GPU