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PEMERINTAH KABUPATEN TAPANULI UTARARSU SWADANA DAERAH TARUTUNG

Jl. AGUS SALIM No. 1 Tarutung 22411

Telp. ( 0633 ) 21303, Telp. Inor!a"# $ ( 0633 ) 2034% &a'. $ ( 0633 ) 2040e*"#te $ +++.r"utarutung.org$ -!a#l $ r"utarutung/aoo.o.#

LAPORAN RUSAK / PERBAIKAN

Tarutung, ..........................2011

epaa $ In"tala"# e!el#araan Sarana 5an ra"arana u!a Sa7#t S+aana 5aera Tarutung e*utuan

ol/8uangan8antor $ ...............................................................

Moon per*a#7an $ ...............................................................

eluan $ ...............................................................

Analisa Perbaikan :

1. ...........................................................................................

2. ...........................................................................................

3. ...........................................................................................

Tindakan / Keb!"an Perbaikan :

1. ...........................................................................................

2. ...........................................................................................

3. ...........................................................................................

PEMERINTAH KABUPATEN TAPANULI UTARARSU SWADANA DAERAH TARUTUNG

Jl. AGUS SALIM No. 1 Tarutung 22411

Telp. ( 0633 ) 21303, Telp. Inor!a"# $ ( 0633 ) 2034% &a'. $ ( 0633 ) 2040

e*"#te $ +++.r"utarutung.org$ -!a#l $ r"utarutung/aoo.o.#

LAPORAN RUSAK / PERBAIKAN

Tarutung, ..........................2011

epaa $ In"tala"# e!el#araan Sarana 5an ra"arana u!a Sa7#t S+aana 5aera Tarutung e*utuan

ol/8uangan8antor $ ..................................................................

Moon per*a#7an $ ..................................................................

eluan $ ..................................................................

Analisa Perbaikan :

1. ...........................................................................................

2. ...........................................................................................

3. ...........................................................................................

Tindakan / Keb!"an Perbaikan :

1. ...........................................................................................2. ...........................................................................................

3. ...........................................................................................

elapor $

#$$$$$$$$%

5#per#7"a8Sele"a##7er9a7an $

#$$$$$$$$%

epala ISS $

(Ir#" angga*ean, S)

NI.1%66111:1%;;031004

5#7etau#,

a. A! < Mana9.

(*a" A. Na#nggolan, S)

NI.1%60;2%1%;:031003

elapor $

#$$$$$$$$%

5#per#7"a8Sele"a#

#7er9a7an $

#$$$$$$$$%

epala ISS $

(Ir#" angga*ean, S)

NI.1%66111:1%;;031004

5#7etau#,

a. A! < Mana9.

(*a" A. Na#nggolan, S)

NI.1%60;2%1%;:031003

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