| No | No Samb | Nama | Alamat | Tarif Lama | Rekomendasi | Ket | Catatan | TTD | Foto |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 001398 | AHMAD ZAKARIA | DARSONO Gg RJWLI 57 | B2 | B2 | ![]() | |||
| 2 | 026309 | ANGGUN RAHAYU | JL. DARSONO GG RAJAWALI NO 101 RT.4 RW.9 | B2 | B2 | ![]() | |||
| 3 | 030194 | ANIK HARTATIK | JL. DARSONO GG. MERPATI RT 3 RW 9 | B1 | B1 | ![]() | |||
| 4 | 002075 | ARIFIN | JL. DARSONO I/18 | B2 | B2 | ![]() | |||
| 5 | 002048 | BUDI | SUROPATI I/1 RT 5/13 | B2 | B2 | ![]() | |||
| 6 | 001867 | HARIYATI | SUROPATI 35 RT 4/13 | B2 | B2 | ![]() | |||
| 7 | 002076 | HJ. SUKARTIN | JL.DARSONO I/18 | B2 | B2 | ![]() | |||
| 8 | 032852 | LASRI | JL LESTI KAMPUNG DAMAI NO 44 | B2 | B2 | ![]() | |||
| 9 | 026275 | MADSIARI | BRANTAS II 07 RT.1 RW.1 | B1 | B1 | ![]() | |||
| 10 | 001131 | MARDJANI | KASIMAN 182D RT I/V | B2 | B2 | ![]() | |||
| 11 | 021986 | MARSUTIK | JL.DARSONO Gg.KUTILANG 30A | B2 | B2 | ![]() | |||
| 12 | 026285 | MASRIATUN | JLN BRANTAS II NO 20 RT.1 RW.1 | B2 | B2 | ![]() | |||
| 13 | 001095 | MOCH. ATIM | SUROPATI II RT 2/13 | B2 | B2 | ![]() | |||
| 14 | 001079 | NITI REDJO | SUROPATI RT 2/13 | B2 | B2 | ![]() | |||
| 15 | 001747 | NUR HADI | PANGLIMA SUDIRMAN | B2 | B2 | ![]() | |||
| 16 | 000909 | RUCHAYATIN | JL.DARSONO | B2 | B2 | ![]() | |||
| 17 | 001842 | S Y A K R I | M SAHAR 20 RT 8/13 | B2 | B2 | ![]() | |||
| 18 | 001843 | SUMO SAMAPAN | SUROPATI I/37 RT 8/13 | B2 | B2 | ![]() | |||
| 19 | 000717 | SUNARSIH | SUDARNO | B2 | B2 | ![]() | |||
| 20 | 025535 | SUTINEM | JLN LESTI UTARA RT.4 RW.3 | B2 | B2 | ![]() | |||
| 21 | 001837 | SUWADI | M SAHAR 19 RT 8/13 | B2 | B2 | ![]() |
Mengetahui,
Kabag Hublang & Pemasaran
Menyetujui,
Kabag Teknik