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FUMIGATION CERTIFICATE

Certificate Number : 696/BF/FUM/III-17 Registration Number : ID. 0123MB


This is to certify the following regulated article has been fumigated according to the appropriate procedures
to conform with the current phytosanitay requirements of the importing country.
ARTICLE DETAIL
Description Of Goods : 20 PCS OF HANDICRAFT
Quantity Declared : 2 WOODEN CASES Distinguishing marks :-
Consigment Link : BILL OF LADING NUMBER : BLRTD0010613
Country of origin : BALI - INDONESIA Port of Loading : SURABAYA
Country of Destination : NETHERLANDS Declared point of entry : ROTTERDAM
Consignor/Shipper : CV. CAHYA PESONA INT’L
PERUM VALUVANA RESIDEN KAV. I/3
KEL. LUKLUK, KEC. MENGWI, KAB. BADUNG,
BALI – INDONESIA
Consignee/Buyer : BRITTA VON WEDEL
SIMPLY PURE (PART OF EXHIBITION SCOUT)
KLEINE HOUTWEG 81
2012CC HAARLEM
NEDERLAND
PH : 0031642731136
Notify Party : SAME AS CONSIGNEE
TREATMENT DETAILS
Name of fumigant : Methyl Bromide (CH3Br) Date of fumigantion : March 17. 2017
Dosage : 48 gr/m3 Duration of fumigation : 24 hours
Minimum Air Temperaturincontainer : 240C Fruit temperature :-
Place of fumigation : At Warehouse DAVID BALICARGO
Fumigation carried out under gas tight enclousure/sheet : Yes □No □N/A
Fumigation performed in a container : □Yes No □N/A
Container meets pressure test requirements : □Yes □No N/A
Container has free air space in accordance with the methyl bromide :
standard □Yes No □N/A
Container has been ventilated to bellow 5 ppm v/v methyl bromide : □Yes No □N/A
WRAPPING AND TIMBER
Has the commodity been fumigated to lacquiering, varnishing, painting :
or wrapping ? □Yes No □N/A
Has plastic wrapping been used in the consignment ? : Yes □No □N/A
➢ If yes, has the consignment been fumigated prior to plastic :
wrapping □Yes No □N/A
➢ Or has the plastic wrapping been slashed, opened or perforated in :
accordance with the AQIS wrapping perporationstandard ?
Yes □No □N/A
Is the timber in this consignment less than 200mm thick in one :
dimension and correctly spaced every 200mm in height ?
Yes □No □N/A
ADITIONAL DECLARATIONS
The fumigation treatment has no residual effect to prevent reinvestation of common insect after 21 days, therefore we can offer
no guarantees in the respect after that.
I declared that these datails are true and correct and the fumigation has been carried out in accordance with The Australian
Methyl Bromide Standard. The target of this fumigation is for the packing fumigation.

Denpasar, April 01. 2017


Manager &Licenced fumigator
Bambang Setiawan

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