| No | No Samb | Nama | Alamat | Tarif Lama | Rekomendasi | Ket | Catatan | TTD | Foto |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 032860 | KARIONO | JL INDRAGIRI GG XXI RT 005/ RW 001 | B2 | B2 | Yg punya rumah tua dan sakit | ![]() | ||
| 2 | 026734 | LASIMUN | DESA SUMBEREJO RT.5 RW.8 | B2 | B2 | ![]() | |||
| 3 | 008128 | M A H M U D | SUMBEREJO RT 1/5 | B2 | B2 | ![]() | |||
| 4 | 007907 | P. WARNIM | SANTREAN RT 5 / RW 1 | B2 | B2 | ![]() | |||
| 5 | 026721 | RIRIN KUSNIAWATI | JL.INDRAGIRI SUMBEREJO RT.4 RW.8 | B2 | B2 | ![]() | |||
| 6 | 008126 | S A I M I N | SUMBERSARI | B2 | B2 | ![]() | |||
| 7 | 019882 | SARMIN | SANTREAN RT 5/1 | B2 | B2 | ![]() | |||
| 8 | 008325 | SUMARI | SANTREAN 12 RT06/02 | B2 | B2 | ![]() | |||
| 9 | 008333 | SUNARI | SUMBERSARI RT03/03 | B2 | B2 | ![]() | |||
| 10 | 008323 | SUNTARI | SANTREAN 7 RT06/02 | B2 | B2 | ![]() | |||
| 11 | 026722 | SUPARMAN | SUMBEREJO RT.4 RW.8 | B2 | B2 | ![]() | |||
| 12 | 008229 | SURADJI | SANTREAN RT 2/2 | B2 | B2 | ![]() | |||
| 13 | 030333 | SUWARNI | SUMBEREJO RT 1 RW 1 | B1 | B1 | ![]() | |||
| 14 | 008319 | WIYONO | SANTREAN RT03/02 | B2 | B2 | ![]() |
Mengetahui,
Kabag Hublang & Pemasaran
Menyetujui,
Kabag Teknik