ISCC Application Form - PT. SBC Asia Sertifikasi

Company Information

Company Name *

Legal Form of the Company * (Pte Ltd, Co.Ltd, PT, Sdn Bhd, CV, cooperative, .....)

Office Address *

Location of Operation Unit to be Certified (if the address is different from registered company as above)

National Trade Register ID Type and Number * e.g., Indonesia – NIB

VAT ID (Tax Identification No.) *

Telephone *

Email *

Website (if any)

Contact Person (as registered in ISCC)

Name *

Position *

Phone Number *

Email *

ISCC Registration No. (only applicable for Re-certification)

Audit Information

ISCC System *

ISCC EU

ISCC PLUS

ISCC Japan - Fit

ISCC Corsia

Type of Audit *

Initial audit (new client)

Re-certification

Recertification with transfer from another CB

Surveillance audit

Additional / change of scope

Additional Material

Verification of Change of GHG Value

Production Capacity (only applicable for Palm Oil Mill)

0 up to 5 mt FFB/hour

5.1 up to 10 mt FFB/hour

10.1 up to 20 mt FFB/hour

20.1 up to 45 mt FFB/hour

45.1 up to 60 mt FFB/hour

more than 60 mt FFB/hour

Production Capacity (Applicable for other processing unit)

0 up to 100,000 mt/year

100,001 up to 250,000 mt/year

250,001 up to 500,000 mt/year

more than 500,000 mt/year

Turn Over in (€) per/year

< 3 Million Euro

< 60 Million Euro

< 150 Million Euro

< 500 Million Euro

> 500 Million Euro

GHG Applied *

Total Default Value

Disaggregated Default Value

Actual Value

Design Value (only applicable for initial audit)

Others Certified Scheme?

RSPO

ISPO

MSPO

RSB

Other:

Scope Proposed

Note: For Processing Unit, please mention type of processing unit in the field below

Type of Processing Unit (if applicable)

Type of Raw Material & Product Applicable only for plantation, processing unit, Collecting point, Point of origin (Not applicable for warehouse and trader/trader with storage)

Raw Material:

Intermediate Product:

Final Product:

Important: For POME oil material, it must be individually certified. POME oil can't be under the scope of collecting Point

Do you trade, handle, process or store waste/residue raw materials?

Yes

No

Do you trade, handle or store both waste and residues (e.g. Used Cooking oil or animal fat) as well as virgin vegetable oils?

Yes

No

Do you trade, handle, process or store waste/residue-based products? Eg. Refined POME oil, Refined SBE oil, Refined PFAD

Yes

No

Do you trade, process or store biogas/biomethane?

Yes

No

Are you intending to handle recycled material? (eg. Based on mixed plastic waste)

Yes

No

1. FARM / PLANTATION

Name of Certification Unit (only applicable for individual certified, central office and FGP, not applicable for sample of farm)

Location / Address (only applicable for individual certified, central office and FGP, not applicable for sample of farm)

Number of Farm / Plantation (unit)

Type of Raw Material

Are any Land Use Change?

Yes

No

Farm / Plantation has land title?

Yes

No

ARIA Report generated for all plantations?

Yes

No

Name of Farm / Plantation

No.	Name of Plantation	Hectarage	Location/Address
1
2
3
4
5
6

*Please add row as needed

2. PROCESSING UNIT

Name of Certification Unit

Location / Address of Operational Unit

Is the processing unit contracted by the feedstock owner under a tolling agreement?

Yes

No

If yes: Please provide the legal name and address of the processing unit

Production Capacity (in mt)

Is Processing unit has storage?

Yes

No

Is there storage same location of operational unit? (internal storage)

Yes

No

Is there storage different location of operational unit? (external storage)

Yes

No

If yes: how many location?

How many individual ISCC certified:

How many non ISCC certification:

Name and Address of Storage under Processing Unit

No.	Name of Storage	Internal/External	Certificate Number	Address
1
2

*Please add row as needed

3. TRADER (TR)

Name of Certification Unit

Address / Location

4. TRADER WITH STORAGE (TRS)

Name of Certification Unit

Address / Location

Is there storage same location of operational unit? (internal storage)

Yes

No

Is there storage different location of operational unit? (external storage)

Yes

No

If yes: how many location?

How many individual ISCC certified:

How many non ISCC certification:

Name and Address of Storage under TRS

No.	Name of Storage	Internal/External	Certificate Number	Address
1
2
3
4

*Please add row as needed

5. LOGISTIC CENTRE (LC)

Name of Certification Unit

Address / Location

How many storage under logistic centre - Individual ISCC certified:

How many storage under logistic centre - Non ISCC certification:

Name and Address of Storage under Logistic Centre

No.	Name of Storage	Internal/External	Address
1
2
3
4

*Please add row as needed

6. WAREHOUSE (WH)

Name of Certification Unit

Address / Location

7. COLLECTING POINT (CP)

Name of Certification Unit

Address / Location

Type of Material Handled

PoO under Collecting Point

Number of PoO (unit) Only applicable for Non POME oil

Number of PoO – generation more than 5 mt/month or >60 mt/year (unit)

Name and Address of PoO under Collecting Point (generation more than 5 mt/month or >60 mt/year)

No.	Name of PoO	Address
1
2
3
4
5

*If many PoO, please kindly send the list

Storage at Collecting Point

Is Collecting Point has storage?

Yes

No

Is there storage same location of operational unit? (internal storage)

Yes

No

Is there storage different location of operational unit? (external storage)

Yes

No

If yes: how many location?

How many individual ISCC certified:

How many non ISCC certification:

Name and Address of Storage under Collecting Point

No.	Name of Storage	Internal/External	Address
1
2

*Please add row as needed

Dependent Collecting Point

Is Collecting Point has Dependent CP?

Yes

No

Name and Address of Dependent Collecting Point

No.	Name of DCP	Address
1
2
3
4

*Please add row as needed

8. POINT OF ORIGIN (PoO) – ONLY APPLICABLE FOR PoO INDIVIDUAL CERTIFIED

Name of Certification Unit (only applicable for individual certified, central office and FGP, not applicable for sample of PoO)

Location / Address (only applicable for individual certified, central office and FGP, not applicable for sample of PoO)

Type of Material Handled/Generated

Type of Business Generated Waste/Residue

Number of PoO under Central Office or FGP (waste/residue)

Number of PoO – generation less than 10 mt/month or 120 mt/year:

Number of PoO – generation more than 10 mt/month or 120 mt/year:

Name and Address of PoO under Central Office or FGP (generation more than 5 mt/month or >60 mt/year)

No.	Name of PoO	Address
1
2
3
4
5
6
7

*If many PoO, please kindly send the list

Additional Information

Billing Address (if different from company registered)

Other Informations?

Document Required Submitted to CB (Applicable for initial audit only)

Internal audit

ISCC training

PT. SBC ASIA SERTIFIKASI