Page 256 - PERMENAKER 8 2020
P. 256
- 249 -
b. Stiker tidak memenuhi syarat K3
KOP SURAT
TIDAK MEMENUHI SYARAT K3
NAMA PESAWAT : ..................................................................................................................
NO. SURAT KETERANGAN : ..................................................................................................................
TIDAK MEMENUHI SYARAT
K3
KAPASITAS : .................................................................................................................
NO. SERIE : ..................................................................................................................
TANGGAL PEMERIKSAAN : ..................................................................................................................
DAN PENGUJIAN
SYARAT-SYARAT YANG : ..................................................................................................
HARUS DIPENUHI ..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
PALING LAMBAT......................................................................................
NAMA AHLI K3 / : ..................................................................................................................
PENGAWAS
KK SP. PAA
NO. REG AHLI K3 SP. PAA / : ..................................................................................................................
SKP PENGAWAS KK SP. PAA
TTD AHLI K3 / PENGAWAS :
KK SP. PAA