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DAFTAR PEMERIKSAAN SAMPEL DI BALAI LABORATORIUM KESEHATAN LINGKUNGAN

BULAN : Juni 2016

ASAL SAMPEL JENIS SAMPEL DIPERIKSA Jumlah


No. Ket
Sampel
ASAL SAMPEL Alamat Mak/Min Air Limbah R.Swab
1 Hotel Sunggal Jl. Binjai KM 8,7 Psr V Medan 1 0 0 0 1

2 DAM Mahfirah Water Jl. Boxit Gg Setia No 27 Kota Bangun Medan Deli 0 1 0 0 1
3 DAM VIP Water Jl. Cengkeh Raya No 65 Medan 0 1 0 0 1
4 DAM Joy RO OXY Jl. Cengkeh Raya 0 1 0 0 1
5 DAM HJ. Halimah Water Jl. Jahe Raya No 30 0 1 0 0 1
6 DAM Segar Water Jl. Nilam Raya No 97 0 1 0 0 1
7 DAM Tiyo Water Jl. Bukit Barisan I 0 1 0 0 1
8 RSU Madani Medan Jl. AR. Hakim No 168 1 0 0 0 1
9 RSU Madani Medan Jl. AR. Hakim No 168 1 0 0 0 1
10 RSU Madani Medan Jl. AR. Hakim No 168 1 0 0 0 1
11 DAM Parna Water Jl. Pelajar Timur No 51 0 1 0 0 1
12 Bebek Tepi Sawah Jl. W. Mongonsidi No 45 Hermes Place Medan 1 0 0 0 1
13 Bebek Tepi Sawah Jl. W. Mongonsidi No 45 Hermes Place Medan 1 0 0 0 1
14 Sinar Medan Jl. Rencong No 38 B 1 0 0 0 1
15 Sinar Medan Jl. Rencong No 38 B 1 0 0 0 1
16 Vitalia Jl. Brij. Katamso Dalam LK III No 56 1 0 0 0 1
17 Vitalia Jl. Brij. Katamso Dalam LK III No 56 1 0 0 0 1
18 Vitalia Jl. Brij. Katamso Dalam LK III No 56 1 0 0 0 1
19 Vitalia Jl. Brij. Katamso Dalam LK III No 56 1 0 0 0 1
20 DAM Permata Water Jl. Mangaan VI Psr II Mabar 0 1 0 0 1
21 DAM HN Water Jl. Sari Kenanga Kel. Sari Kenanga Kec. Bantahan 0 1 0 0 1
22 RSU Bahagia Jl. Bahagia No 85 0 1 0 0 1
23 RSU Bahagia Jl. Bahagia No 85 1 0 0 0 1
24 DAM Monica Water Jl. Kapt Muslim Gg Gotong Royong Helvetia 1 0 0 0 1
25 Catering PT. Samudra Pangan Lestari Jl. Madio Santoso No 11 Krakatau 1 0 0 0 1
26 Catering PT. Samudra Pangan Lestari Jl. Madio Santoso No 11 Krakatau 1 0 0 0 1
27 RS. Imelda Pekerja medan Jl. Bilal No 24 1 0 0 0 1
28 RS. Imelda Pekerja medan Jl. Bilal No 24 1 0 0 0 1
29 RS. Imelda Pekerja medan Jl. Bilal No 24 1 0 0 0 1
30 DAM Uci Water Jl. Karya Jaya Gg Eka Jati Kel. Gedung Johor 0 1 0 0 1
31 DAM Dini Water Jl. Karya Jaya No 279 c Kel. Gedung Johor 0 1 0 0 1
32 DAM Umi Water Jl. Eka Surya No 109 Kel. Gedung Johor 0 1 0 0 1
33 Rumah Makan M&R Jl. Waja No 2 1 0 0 0 1
34 Rumah Makan M&R Jl. Waja No 2 1 0 0 0 1
35 Restoran lembur Kuring Jl. T.Amir Hamzah N0o 85 1 0 0 0 1
36 Restoran lembur Kuring Jl. T.Amir Hamzah N0o 85 1 0 0 0 1
37 DAM Friend's Water Jl. Utama N0 147 A Kel. Kota Matsum II 0 1 0 0 1
38 PT. Maju Jaya Pohon Pinang Jl. Pajak Sambar No 37/4 1 0 0 0 1
39 PT. Maju Jaya Pohon Pinang Jl. Pajak Sambar No 37/4 1 0 0 0 1
40 PT. Maju Jaya Pohon Pinang Jl. Pajak Sambar No 37/4 1 0 0 0 1
41 PT. Maju Jaya Pohon Pinang Jl. Pajak Sambar No 37/4 1 0 0 0 1
42 Kerupuk Mahkota Jl. Rinte Raya No 140 Simpang Selayang 1 0 0 0 1
43 Kerupuk Mahkota Jl. Rinte Raya No 140 Simpang Selayang 1 0 0 0 1
44 Madu Nabawi Jl. W. Iskandar Komp.IAIN No 24/8 1 0 0 0 1
45 Madu Nabawi Jl. W. Iskandar Komp.IAIN No 24/8 1 0 0 0 1
46 DAM Iwan Water Jl. Jamin Gintin Sp. Simalingkar 0 1 0 0 1
47 DAM Shifa Water Jl. Mesjid Lr III Purba Sari P.Siantar 0 1 0 0 1
48 DAM Lafifa RO Jl. Mawar Medan Polonia 0 1 0 0 1
49 Ayam Penyet Sidoarjo Jl. Bunga Lau Kel. Kemenangan Tani 1 0 0 0 1
50 Ayam Penyet Sidoarjo Jl. Bunga Lau Kel. Kemenangan Tani 1 0 0 1
51 DAM Oke Water Jl. Jamin Ginting KM 7,5 0 1 0 0 1
52 DAM Berlin Gio Water Jl. Pembangunan USU Lorong Kabung No 9 0 1 0 0 1
53 Ayam Penyet Wonosobo 77 Jl. Jamin Ginting Kel Mangga 1 0 0 1
54 Bakery & Cake Shop Hasbilah Jl. Jend. AH Nasution gg Khadi No 1 LK XIV M. Johor 1 0 0 0 1
55 Bakery & Cake Shop Hasbilah Jl. Jend. AH Nasution gg Khadi No 1 LK XIV M. Johor 1 0 0 0 1
56 Bakery & Cake Shop Hasbilah Jl. Jend. AH Nasution gg Khadi No 1 LK XIV M. Johor 1 0 0 0 1
57 Usaha Goreng Pisang banana Crispy Jl. Jamin Ginting blok Topaz No 41 1 0 0 0 1
58 CV Azizah Jl. Karya selamat No 17 P. Mansyur 1 0 0 0 1
59 CV Azizah Jl. Karya selamat No 17 P. Mansyur 1 0 0 0 1
60 CV Humairah Jl. Karya Kasih Pipa I gg No 10 P. Mansyur 1 0 0 0 1
61 CV Humairah Jl. Karya Kasih Pipa I gg No 10 P. Mansyur 1 0 0 0 1
62 Papa Roti Jl. Karantina I No 9 glugur Darat 1 0 0 0 1
63 Papa Roti Jl. Karantina I No 9 glugur Darat 1 0 0 0 1
64 Papa Roti Jl. Karantina I No 9 glugur Darat 1 0 0 0 1
65 Papa Roti Jl. Karantina I No 9 glugur Darat 1 0 0 0 1
66 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 1 0 0 0 1
67 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 1 0 0 0 1
68 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 1 0 0 0 1
69 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 1 0 0 0 1
70 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 1 0 0 0 1
71 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 1 0 0 0 1
72 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 0 1 0 0 1
73 Santika Dyandra Hotel & Convention Jl. Kapten maulana Lubis 0 1 0 0 1
74 Pemb. Tempe Usaha tempe Bersama Jl. Teratai gg Serasi Lk V Polonia 1 0 0 0 1
75 DAM Michael Water Jl. Pantai Timur no 9 0 1 0 0 1
76 DAM 745 Water Jl. Kapten Muchtar basri No 84 0 1 0 0 1
77 DAM Barokah Water Jl. TM Pahlawan Lor Sedar Belawan I 0 1 0 0 1
78 DAM AM 2000 Water Jl. Pukat Banting No 69 0 1 0 0 1
79 DAM Argo Water Jl. Mandala By Pass No 102 0 1 0 0 1
80 DAM Ar-Raudah Water Jl. Denai No 163 B 0 1 0 0 1
81 DAM Daffa Water Jl. Pukat I no 52 0 1 0 0 1
82 Dam Amsro Water Jl. Medan Area Selatan Gg 8 0 1 0 0 1
83 DAM Nada Water Jl. AR Hakim Gg Delapan 0 1 0 0 1
84 DAM Kanen Water Jl. Wahidin No 265 0 1 0 0 1
85 DAM Aan Water Jl. Perkutut ujung / Jl. Gaperta gg Encong Ujung 0 1 0 0 1
86 Pembuatan Roti Jl. Bingkarung No 21 1 0 0 0 1
87 Pembuatan Roti Jl. Bingkarung No 21 1 0 0 0 1
88 DAM Parnma Water Jl. Jamin Ginting No 125 Kel P. Bulan Kec Medan Baru 0 1 0 0 1
89 DAM Berkah Water Jl. Ampera No 58 Sidodadi Batang Kuis 0 1 0 0 1
90 RSU Bunda Thamrin Medan jl. Sei Batang Hari No 28-30 1 0 0 0 1
91 RSU Bunda Thamrin Medan jl. Sei Batang Hari No 28-30 1 0 0 0 1
92 Hotel Garuda Plaza Jl. SM Raja No 18 1 0 0 0 1
93 Hotel Garuda Plaza Jl. SM Raja No 18 1 0 0 0 1
94 Hotel Garuda Plaza Jl. SM Raja No 18 1 0 0 0 1
95 The Harvest Jl. Dr. Cipto No 8 Kel. Anggrung Medan polonia 1 0 0 0 1
96 The Harvest Jl. Dr. Cipto No 8 Kel. Anggrung Medan polonia 1 0 0 0 1
97 Grand swiss Bell Hotel Jl. S. Parman 0 1 0 0 1
98 Grand swiss Bell Hotel Jl. S. Parman 0 1 0 0 1
99 Grand swiss Bell Hotel Jl.S. Parman 0 1 0 0 1
100 Grand swiss Bell Hotel Jl. S. Parman 1 0 0 0 1
101 Grand swiss Bell Hotel Jl. S. Parman 1 0 0 0 1
102 Grand swiss Bell Hotel Jl. S.Parman 1 0 0 0 1
103 Grand swiss Bell Hotel Jl. S. Parman 1 0 0 0 1
104 Pemb. Tahu CAN Jl. Flamboyan No 1-C Gg Aperbatasan Kec. Medan Tunt 1 0 0 0 1
105 Toko Roti Judens Jl. Jamin ginting 1 0 0 0 1
106 Toko Roti Judens Jl. Jamin Ginting 1 0 0 0 1
107 Under Contruction Bar & Bistro (Rest) Komp. Hermes Place Polonia Level 2 1 0 0 0 1
108 Under Contruction Bar & Bistro (Rest) Komp. Hermes Place Polonia Level 2 1 0 0 0 1
109 Golden Dragon Seafood Restaurant Jl. W. Mongonsidi No 45 1 0 0 0 1
110 Golden Dragon Seafood Restaurant Jl. W. Mongonsidi No 45 1 0 0 0 1
111 Charlie Brown Café (restaurant) Komp. Hermes Place Level 1 A 05-06 1 0 0 0 1
112 Charlie Brown Café (restaurant) Komp. Hermes Place Level 1 A 05-06 1 0 0 0 1
113 DAM Ferino Water Jl. Sentosa Dusun V Kec. Sei Rampah 0 1 0 0 1
114 DAM Zaki Water Dusun I Kel. Sei Baharu Kec. Hamparan Perak 0 1 0 0 1
115 Toko Roti Aroma Jl. Pinang Baris/ Tb. Simatupang 1 0 0 0 1
116 Toko Roti Aroma Jl. Dr. Masur No 170 1 0 0 0 1
117 Toko Roti Aroma Jl. Halat/ Megawati no 1E-F 1 0 0 0 1
118 Toko Roti Aroma Jl. Sisinga Mangaraja XII KM 6,5 No 29 1 0 0 0 1
119 Toko Roti Aroma Jl. Jend. AH Nasution No 31 B-C 1 0 0 0 1
120 DAM Charly Water Jl. Jamin Ginting gg. Sarmin 61 p. Bulan 0 1 0 0 1
80 40 0 0 120

BALAI LABORATORIUM
KESEHATAN LINGKUNGAN MEDAN

Gemala Sari, SKM


Pembina
Nip. 19620604.198212.2.001
Pemeriksaan Jumlah
Bact 101
KT 8
KL 11
Total 120
Jenis N Tgl. Periksa Tgl. Setor Tgl. Daluarsa Nama Sampel

Bact 1 4-Apr-16 10-Jun-16 12-Apr-17 Jus Jeruk


Bact 1 4-Apr-16 10-Jun-16 12-Jul-16 Air Minum
Bact 1 05-Ap-16 10-Jun-16 12-Jul-16 Air Minum
Bact 1 5-Apr-16 10-Jun-16 12-Jul-16 Air Minum
Bact 1 5-Apr-16 10-Jun-16 12-Jul-16 Air Minum
BAct 1 5-Apr-16 10-Jun-16 12-Jul-16 Air Minum
Bact 1 6-Apr-16 10-Jun-16 12-Jul-16 Air Minum
Bact 1 6-Apr-16 10-Jun-16 6-Apr-17 Semur Ayam
Bact 1 6-Apr-16 10-Jun-16 6-Apr-17 Bubur Nasi Putih
Bact 1 6-Apr-16 10-Jun-16 6-Apr-17 Sayur Tumis Buncis
Bact 1 7-Apr-16 10-Jun-16 15-Jul-16 Air Minum
Bact 1 7-Apr-16 10-Jun-16 15-Apr-17 Sate Lilit
Bact 1 7-Apr-16 10-Jun-16 15-Apr-17 Bebek Goreng
Bact 1 4-Apr-16 10-Jun-16 12-Apr-17 Roti Manis
KT 1 4-Apr-16 10-Jun-16 12-Apr-17 Roti Manis
Bact 1 6-Apr-16 10-Jun-16 12-Apr-17 Kue Cucur Keju
KT 1 6-Apr-16 10-Jun-16 12-Apr-17 Kue Cucur Keju
Bact 1 6-Apr-16 10-Jun-16 12-Apr-17 Kue Bangkit
KT 1 6-Apr-16 10-Jun-16 12-Apr-17 Kue Bangkit
Bact 1 8-Apr-16 10-Jun-16 18-Jul-16 Air Minum
KL 1 8-Apr-16 10-Jun-16 18-Jul-16 Air Minum
KL 1 11-Apr-16 10-Jun-16 21-Jul-16 Air Bersih
Bact 1 11-Apr-16 10-Jun-16 11-Apr-17 Ikan Dencis Goreng
Bact 1 11-Apr-16 10-Jun-16 18-Jul-16 Air Minum
Bact 1 11-Apr-16 10-Jun-16 18-Apr-17 Ayam Goreng
Bact 1 11-Apr-16 10-Jun-16 18-Apr-17 Rendang Daging
Bact 1 12-Apr-16 10-Jun-16 12-Apr-17 Cumi Goreng Tepung
BAct 1 12-Apr-16 10-Jun-16 12-Apr-18 Ayam Gulai
Bact 1 12-Apr-16 10-Jun-16 12-Apr-16 Agar- agar
Bact 1 12-Apr-16 10-Jun-16 18-Jul-16 Air Minum
Bact 1 12-Apr-16 10-Jun-16 18-Jul-16 Air Minum
Bact 1 12-Apr-16 10-Jun-16 18-Jul-16 Air Minum
Bact 1 12-Apr-16 10-Jun-16 18-Apr-17 Nasi Goreng
Bact 1 12-Apr-16 10-Jun-16 18-Apr-17 Jus Jeruk
Bact 1 13-Apr-16 10-Jun-16 20-Apr-17 Sate Ayam
Bact 1 13-Apr-16 10-Jun-16 20-Apr-17 Jus Jeruk
Bact 1 13-Apr-16 10-Jun-16 20-Jul-16 Air Minum
Bact 1 14-Apr-16 10-Jun-16 20-Apr-17 Pohon Pinang Marquisa
Bact 1 14-Apr-16 10-Jun-16 20-Apr-17 pohon Pinang Melon
Bact 1 14-Apr-16 10-Jun-16 20-Apr-17 Pohon Pinang Cocopandan
Bact 1 14-Apr-16 10-Jun-16 20-Apr-17 Pohon Pinang Lychee
Bact 1 12-Apr-16 10-Jun-16 25-Apr-17 Kerupuk
KT 1 12-Apr-16 10-Jun-16 25-Apr-17 Kerupuk
Bact 1 15-Apr-16 10-Jun-16 25-Apr-17 Madu
KT 1 15-Apr-16 10-Jun-16 25-Apr-17 Madu
Bact 1 12-Apr-16 10-Jun-16 25-Jul-17 Air Minum
KL 1 18-Apr-16 10-Jun-16 25-Jul-16 Air Minum
KL 1 18-Apr-16 10-Jun-16 25-Jul-16 Air Minum
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Ayam Penyet
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Sambal
KL 1 18-Apr-16 24-Jun-16 25-Jul-16 Air Minum
KL 1 18-Apr-16 24-Jun-16 25-Jul-16 Air Minum
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Ayam Penyet
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Roti Pisang Coklat
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Spong Ceres
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Risol Buncis
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Pisang Goreng
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Kari Daging
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Cap cai
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Ikan Merah Goreng
Bact 1 15-Apr-16 24-Jun-16 25-Apr-17 Soto Madura
Bact 1 19-Apr-116 24-Jun-16 25-Apr-17 Roti sobek coklat
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Roti Kacang Merah
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Roti Tawar
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Sri Kaya
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Jus Jeruk
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Jus Semangka
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Jus Nenas
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Bakso
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Gado-gado
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Daging Bambu
Bact 1 19-Apr-16 24-Jun-16 25-Jul-16 Air Minum
KT 1 19-Apr-16 24-Jun-16 25-Jul-16 Air Kolam Berenang
Bact 1 19-Apr-16 24-Jun-16 25-Apr-17 Tempe
Bact 1 19-Apr-16 24-Jun-16 25-Jul-16 Air Minum
Bact 1 20-Apr-16 24-Jun-16 25-Jul-16 Air Minum
KL 1 20-Apr-16 24-Jun-16 27-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
KL 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Jul-16 Air Minum
Bact 1 21-Apr-16 24-Jun-16 29-Apr-17 Roti Manis
Bact 1 21-Apr-16 24-Jun-16 29-Apr-17 Roti TAwar
KL 1 25-Apr-16 24-Jun-16 13-Aug-16 Air Minum
Bact 1 3-May-16 24-Jun-16 13-Aug-16 Air Minum
Bact 1 29-Apr-16 24-Jun-16 13-May-17 Tumis Labu Kuning
Bact 1 29-Apr-16 24-Jun-16 13-May-16 Ikan Car
BAct 1 4-May-16 24-Jun-16 13-May-17 Ayam Goreng Bawang
Bact 1 4-May-16 24-Jun-16 13-May-17 Gulai Daun Ubi Tumbuk
Bact 1 4-May-16 24-Jun-16 13-May-17 Orange Juice
Bact 1 4-May-16 24-Jun-16 13-May-17 Red cherry Danish
Bact 1 4-May-16 24-Jun-16 13-May-17 Chocolate Devil
KT 1 25-Apr-16 24-Jun-16 13-Aug-16 Air Kolam renang
KT 1 25-Apr-16 24-Jun-16 25-Jul-16 Air Spa
Bact 1 25-Apr-16 24-Jun-16 13-Aug-16 Air Minum
Bact 1 25-Apr-16 24-Jun-16 13-May-17 Beed Black Papper
Bact 1 25-Apr-16 24-Jun-16 13-May-16 Opor Ayam
BAct 1 25-Apr-16 24-Jun-16 13-May-17 Laksa Ikan Kakap
Bact 1 25-Apr-16 24-Jun-16 13-May-17 Orange Juice
Bact 1 26-Apr-16 24-Jun-16 13-May-17 Tahu
Bact 1 26-Apr-16 24-Jun-16 13-May-16 Roti TAwar
Bact 1 26-Apr-16 24-Jun-16 13-May-17 Bolu Gulung
Bact 1 27-Apr-16 24-Jun-16 13-May-17 Martabak Ayam Indomie
Bact 1 27-Apr-16 24-Jun-16 13-May-17 Kwetiaw Sea Food Belacan
Bact 1 27-Apr-16 24-Jun-16 13-May-17 Bebek Steam Goreng
Bact 1 27-Apr-16 24-Jun-16 13-May-17 Ikan Nila Goreng
Bact 1 27-Apr-16 24-Jun-16 13-May-17 Fizza
Bact 1 27-Apr-16 24-Jun-16 13-May-17 Nugget Ikan
BAct 1 27-Apr-16 24-Jun-16 13-Agut-16 Air Minum
KL 1 27-Apr-16 24-Jun-16 13-Agut-16 Air Minum
Bact 1 28-Apr-16 24-Jun-16 13-May-17 Roti Pisang Coklat
Bact 1 28-Apr-16 24-Jun-16 13-May-17 Roti Kacang Hijau
Bact 1 28-Apr-16 24-Jun-16 13-May-17 Roti Kelapa
Bact 1 28-Apr-16 24-Jun-16 13-May-17 Roti Coklat zebra
Bact 1 28-Apr-16 24-Jun-16 13-May-17 Roti Abon
KL 1 28-Apr-16 24-Jun-16 13-Aug-16 Air Minum
DAFTAR PEMERIKSAAN SAMPEL DI BALAI LABORATORIUM KESEHATAN LINGKUNGAN
BULAN : Juli 2016

ASAL SAMPEL JENIS SAMPEL DIPERIKSA Jumlah


No. Ket
Sampel
ASAL SAMPEL Alamat Mak/Min Air Limbah R.Swab

1 DAM Amanah Water Jl. Air Bersih No.8 0 1 0 0 1


2 Bali Pan Cake Durian Jl. P.Banting IV Gg Teladan No 64 Kel. Bantan M.Temb 1 0 0 0 1
3 Bali Pan Cake Durian Jl. P.Banting IV Gg Teladan No 64 Kel. Bantan M.Temb 1 0 0 0 1
4 CV. Cho-Cho Inti Sejahtera Jl. Kelapa II No 8 1 0 0 0 1
5 CV. Cho-Cho Inti Sejahtera Jl. Kelapa II No 8 1 0 0 0 1
6 CV. Cho-Cho Inti Sejahtera Jl. Kelapa II No 8 1 0 0 0 1
7 CV. Cho-Cho Inti Sejahtera Jl. Kelapa II No 8 1 0 0 0 1
8 CV. Cho-Cho Inti Sejahtera Jl. Kelapa II No 8 1 0 0 0 1
9 CV. Cho-Cho Inti Sejahtera Jl. Kelapa II No 8 1 0 0 0 1
10 Roti Sehati Jl. Sumatera No 51/67 1 0 0 0 1
11 Burger Sumo Jl. Melati Raya No 3 Perumnas Helvetia 1 0 0 0 1
12 Burger Sumo Jl. Melati Raya No 3 Perumnas Helvetia 1 0 0 0 1
13 Segar Sehat Jl. Kalimantan No 11 1 0 0 0 1
14 Segar Sehat Jl. Kalimantan No 11 1 0 0 0 1
15 Hertiv Kompl. Sunggal Mas 1 0 0 0 1
16 Hertiv Kompl. Sunggal Mas 1 0 0 1
17 DAM Buana Water Jl. Pintu Air V Sp. Pos Padang Bulan 0 1 0 0 1
18 DAM Zam - Zami Water Jl. Pelajar No 104B 0 1 0 0 1
19 DAM Farina Water Jl. Rela No.17 0 1 0 0 1
20 DAM Mandiri Water Jl. Bahagia by pass No 21 0 1 0 0 1
21 DAM Pangeran Water Jl. Air Bersih No 150 0 1 0 0 1
22 DAM Permata Water Jl. Saudara No 49 0 1 0 0 1
23 DAM Mael Water Jl. Pintu Air No 7 0 1 0 0 1
24 DAM Aca Water Jl. SM Raja No 182 0 1 0 0 1
25 DAM Aqua Pelangi Water Jl. Pelangi 20 0 1 0 0 1
26 DAM Nazri Water Dusun II Kel. Desa Lama Kec. Hamparan Perak 0 1 0 0 1
27 DAM Chandra Water Jl. Musyawarah C No 90B Kel. Pematang Johar Kec. Pe 0 1 0 0 1
28 Kopi Martabe Jl. Bajak II Gg Kelapa Sawit No 9 1 0 0 0 1
29 Kopi Martabe Jl. Bajak II Gg Kelapa Sawit No 9 1 0 0 0 1
30 Gula Aren Martabe Jl. Bajak II Gg Kelapa Sawit No 9 1 0 0 0 1
31 Gula Aren Martabe Jl. Bajak II Gg Kelapa Sawit No 9 1 0 0 0 1
32 Po Guek Jl. Pukat VIII No 33/27 A 1 0 0 0 1
33 Po Guek Jl. Pukat VIII No 33/27 A 1 0 0 0 1
34 Choco Bakery Jl. Kapt Muslim no 9-10 1 0 0 0 1
35 Choco Bakery Jl. Kapt Muslim no 9-10 1 0 0 0 1
36 Sirup Mbak Bolek Jl. Kol. Sugiono No 2 K/ Jl. Wajir 1 0 0 0 1
37 Sirup Mbak Bolek Jl. Kol. Sugiono No 2 K/ Jl. Wajir 1 0 0 0 1
38 Ny. Lita Jl. Danau Marsabut Kompl. Marsabut Square B-9 1 0 0 0 1
39 Ny. Lita Jl. Danau Marsabut Kompl. Marsabut Square B-9 1 0 0 0 1
40 NY. Lita Jl. Danau Marsabut Kompl. Marsabut Square B-9 1 0 0 0 1
41 Ny. Lita Jl. Danau Marsabut Kompl. Marsabut Square B-9 1 0 0 0 1
42 RSIA Badrul Aini Jl. Bromo Lor Sukri No 18 0 1 0 0 1
43 RSIA Badrul Aini Jl. Bromo Lor Sukri No 18 1 0 0 0 1
44 RSIA Badrul Aini Jl. Bromo Lor Sukri No 18 1 0 0 0 1
45 Pastel Mas Jl. Kompl. Multatuli indah Blok B No 25 1 0 0 0 1
46 Pastel Mas Jl. Kompl. Multatuli indah Blok B No 25 1 0 0 0 1
47 Pastel Mas Jl. Kompl. Multatuli indah Blok B No 25 1 0 0 0 1
48 Pastel MAs Jl. Kompl. Multatuli indah Blok B No 25 1 0 0 0 1
49 DAM Mutiara Water Pasar VII No 43 Tandam Hilir 0 1 0 0 1
50 DAM Edi Water Jl. Utama Kp.Kolam Kec. Percut Sei Tuan 0 1 0 0 1
51 DAM Anugrah Water Jl. Kapt. Batu Sihombing Medan Estate Kec. Persut Se 0 1 0 0 1
52 DAM Hikmah RO Jl. Bilal No 228 0 1 0 0 1
53 DAM Afif Water Jl. Bayangkara 0 1 0 0 1
54 DAM Mayotia Water Jl. Perjuangan 0 1 0 0 1
55 Sinar Pangan Utama Dusun II Pasar VII Tandem Hilir Hamparan Perak 0 1 0 0 1
56 Pembuatan Snack Makanan Jl. Sederhana No 30 Tandem Hilir II 0 1 0 0 1
57 CV. Candy Brand Komp. Taman Binjai Indah Block C 0 1 0 0 1
58 Pemb. Mie Tiaw Jl. Kancil 1 0 0 0 1
59 Pemb. Kopi Jl. Kapt. Jumhana 1 0 0 0 1
60 Pembuatan Gincu Jl. Senangin No 30 D 1 0 0 0 1
61 Pembuatan Gincu Jl. Senangin No 30 D 1 0 0 0 1
62 Hotel Putra Mulia Jl. Gatot Subroto No 62 1 0 0 0 1
63 Hotel Putra Mulia Jl. Gatot Subroto No 62 1 0 0 0 1
64 Hotel Putra Mulia Jl. Gatot Subroto No 62 1 0 0 0 1
65 Hotel Putra Mulia Jl. Gatot Subroto No 62 1 0 0 0 1
66 Hotel Saka Jl. Gagak Hitam No 14 1 0 0 0 1
67 Hotel Saka Jl. Gagak Hitam No 14 1 0 0 0 1
68 Hotel Saka Jl. Gagak Hitam No 14 1 0 0 0 1
69 DAM Eggi Water Jl. Pengabdian Dusun I Bandar Setia 0 1 0 0 1
70 DAM Zam - Zami Water Jl. Mesjid KM 13 Desa Pematang Johar Dusun IX Kec 0 1 0 0 1
71 DAM Ahza Water Jl. Batang Kuis 0 1 0 0 1
72 DAM rezaa Water 0 1 0 0 1
73 Grand Impression Hotel Jl. Setia Budi No 159 1 0 0 0 1
74 Grand Impression Hotel Jl. Setia Budi No 159 1 0 0 0 1
75 Grand Impression Hotel Jl. Setia Budi No 159 1 0 0 0 1
76 Grand Impression Hotel Jl. Setia Budi No 159 1 0 0 0 1
77 Pemb. Kue Kacang "Delima" Jl. Gajah No 40 1 0 0 0 1
78 Pembungkusan Garam Jl. Wahidin Dalam No 22 1 0 0 0 1
79 Penggilingan Kopi Jl. Kapt jumhana Ling IV No 2 1 0 0 0 1
80 Monsta Madu Jl. Sei Kera No 202 Pandau Hilir 1 0 0 0 1
81 Monsta Madu Jl. Sei Kera No 202 Pandau Hilir 1 0 0 0 1
82 Deli Indah JL. Berlian Sari No 75 Kedai Durian 1 0 0 0 1
83 Deli Indah JL. Berlian Sari No 75 Kedai Durian 1 0 0 0 1
84 DAM Anggi Water Jl. Lap II Dusun VII Bandar setia Kec. Percut Sei Tuan 0 1 0 0 1
85 DAM Zikry Water Jl. Mesjid KM 13 Desa Pematang Johar Dusun IX 0 1 0 0 1
86 DAM Aqua Fitra Jl. Karya Kel. Karang Berombak 0 1 0 0 1
87 DAM Raihan Water Jl. KL. Yos Sudarso LK 14 A No 8 0 1 0 0 1
88 DAM Banyu Urip Jl. Marelan Raya No 134 t.600 0 1 0 0 1
89 Pembuatan Roti Kering Jl. Bersama No 59 1 0 0 0 1
90 Pembautan Roti Paten Jl.Asia 1 0 0 0 1
91 Pembuatan Roti Jl. Pukat Banting gg obor No 52 1 0 0 0 1
92 Pembuatan Roti Jl. Pukat Banting No 29 1 0 0 0 1
93 Pembautan Roti Jl. Pukat Banting IV No 20 Medan 1 0 0 0 1
94 Pembuatan Kue Putu Jl. Horas Gg Permai 1 0 0 0 1
95 Pembautan Kue Kering Jl. Horas gg Permai 1 0 0 0 1
96 Pembuatan Kerupuk Ikan Jl. Garuda No 28 B Medan 1 0 0 0 1
97 Pembuatan Roti Jl. Garuda No 10 Medan 1 0 0 0 1

98 DAM Miea Water Jl. Pintu Air IV Sp. Kuala 0 1 0 0 1

99 DAM Jefri Water Jl. Luka Padang Bulan Kel. Bekala Medan 0 1 0 0 1

100 DAM Jimmy RO Jl. Luka No 139 A Simp. Kuala Bekala 0 1 0 0 1

101 DAM Azam Zam Water Jl. Pajak Rambe Ling VI gg Aml Kel Martubung 0 1 0 0 1

102 DAM Sibolangit Water Jl. Pinang Baris No 255 B Sunggal 0 1 0 0 1

103 DAM Setia Kawan Water Jl. Karya Wisata No 89 A. P Mansyur 0 1 0 0 1

104 De Arsik Jl. Jamin Ginting Km 13,7 1 0 0 0 1

105 De Arsik Jl. Jamin Ginting Km 13,7 1 0 0 0 1


106 UD. Maju Jaya Pangan Jl. Perwira No IV 1 0 0 0 1

107 UD. Maju Jaya Pangan Jl. Perwira No IV 1 0 0 0 1

108 UD. Maju Jaya Pangan Jl. Perwira No IV 1 0 0 0 1

109 UD. Maju Jaya PAngan Jl. Perwira No IV 1 0 0 0 1

110 UD. Maju Jaya Pangan Jl. Perwira No IV 1 0 0 0 1

111 UD. Maju Jaya Pangan Jl. Perwira No IV 1 0 0 0 1

112 Papala Pancake Jl. Durian gg Pisang No 35/3 1 0 0 0 1

113 Papala Pancake Jl. Durian gg Pisang No 35/3 0 1 0 0 1

114 DAM Sandi Water Jl. Tuntungan No 21 Desa Baru Pancur Batu 0 1 0 0 1

115 DAM Berkah Water Jl. Petonia Raya Kel. Namo Gajah Kec. Medan Tuntun 0 1 0 0 1

116 DAM Roi Lavenda Jl. Bunga Kemuning No 34 Kel. Baru Ladang Bambu 0 1 0 0 1

117 DAM Daus Water Jl. Jl. Bunga Lau No 22 Kemenangan Tani Medan 0 1 0 0 1

118 DAM Ian Water Jl. Flamboyan Raya No 76 Sp. Melati Kel. Tanjung Sel 0 1 0 0 1

119 DAM Juan Water Jl. Flamboyan Raya No 14 A Tanjung Selamat Kel. Tan 0 1 0 0 1

120 DAM Purba Water Jl. Flamboyan Raya No 17 LK II Tj. Selamat 0 1 0 0 1

121 DAM Riza Water Jl. Sakura No 69 LK I Kel. Tanjung Selamat Kec. Meda 0 1 0 0 1

122 DAM Widia Water Jl. Bunga Cempaka Kel. Titi Rante Kec.Medan Baru 0 1 0 0 1

123 DAM Aquanta Water Desa Merdeka Kel. Medan Baru 0 1 0 0 1

124 DAM Tasya Water Jl. Bahagia No 18 Kel Titi Rante Kec. Medan Baru 0 1 0 0 1

125 DAM Kamboja Water Jl. Jamin Ginting Gg Kamboja Kel. Padang Bulan Kec. 0 1 0 0 1

126 Pembuatan Saus Jl. Buluh Cina Kel. Buluh Cina Hamparan Perak 0 1 0 0 1

127 Phin- Phin Jl. Dewa Ruci No 34 Kel. Petisah tengah 1 0 0 0 1

128 Phin- Phin Jl. Dewa Ruci No 34 Kel. Petisah tengah 1 0 0 0 1

129 Warung Pojok jl. Gatot Subroto Comp. Brastagi No 88 1 0 0 0 1

130 Warung pojok jl. Gatot Subroto Comp. Brastagi No 88 1 0 0 0 1

131 DAM Mulia Water Jl. Alumunium Raya No 27 A 0 1 0 0 1

132 DAM Anugerah Kangen Water Jl. Bunga Lau Ruko Garden Fista No. 18 Kemenangan T 0 1 0 0 1

133 Restaurant Sudi Mampir Sea Fo Jl. Veteran Belawan No. 172/174 1 0 0 0 1

134 Restauran Hawwi Sea Food Jl. Orion No. 81/83 1 0 0 0 1

135 Pembuatan Kecap CV Sinar AbadJl. KL Yos Sudarso KM 2,5 Titi Papan 1 0 0 0 1

136 Pembuatan Kecap CV. Sinar AbadJl. KL Yos Sudarso KM 2,5 Titi Papan 1 0 0 0 1

137 DAM H 5 Water Jl. Sei Wampu Baru No 1 G 0 1 0 0 1

138 DAM Fresh Water Jl. Jamin Ginting No 270 0 1 0 0 1

139 DAM FJ Water Jl. Lindung No 25 Kel. Pandau Hulu II Kec. Medan Are 0 1 0 0 1

140 H S & C Jl. Veteran No 19 J 1 0 0 0 1

141 H S & C Jl. Veteran No 19 J 1 0 0 0 1

142 Pemb. Roti 'Tunas Jaya' Jl. P. Bantinfg IV Buluh Perindu 1 0 0 0 1

143 Pemb. Roti 'Tunas Jaya' Jl. P. Bantinfg IV Buluh Perindu 1 0 0 0 1

144 Pemb. Roti 'Tunas Jaya' Jl. P. Bantinfg IV Buluh Perindu 1 0 0 0 1

145 Pemb. Roti 'Tunas Jaya' Jl. P. Bantinfg IV Buluh Perindu 1 0 0 0 1

146 Pemb. Roti 'Tunas Jaya' Jl. P.Banting IV Buluh Perindu 1 0 0 0 1

147 Pemb. Roti 'Tunas Jaya' Jl. P. Bantinfg IV Buluh Perindu 1 0 0 0 1

148 Pemb. Roti 'Tunas Jaya' Jl. P. Bantinfg IV Buluh Perindu 1 0 0 0 1

149 Pemb. Roti 'Tunas Jaya' Jl. P. Banting IV Buluh Perindu 1 0 0 0 1

150 Pemb. Roti 'Tunas Jaya' Jl. P. Banting IV Buluh Perindu 1 0 0 0 1


94 56

BALAI LABORATORIUM
KESEHATAN LINGKUNGAN MEDAN

Gemala Sari, SKM


Pembina
Nip. 19620604.198212.2.001
Jenis N Tgl. Periksa Tgl. Setor Tgl. Daluarsa Nama Sampel

Bact 1 7-Apr-16 15-Jul-16 13-Agst-16 Air Minum


KT 1 22-Apr-16 15-Jul-16 13-May-17 Pan Cake Durian
Bact 1 22-Apr-16 15-Jul-16 13-May-17 Pan Cake Durian
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Rasa Strawberry
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Rasa Coklat
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Rasa Capucino
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Rasa Blue Berry
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Rasa Mocca
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Rasa Pandan
Bact 1 25-Apr-16 15-Jul-16 4-May-17 Roti Manis
KT 1 26-Apr-16 15-Jul-16 13-May-17 Roti Burger
Bact 1 26-Apr-16 15-Jul-16 13-May-17 Roti Burger
Bact 1 28-Apr-16 15-Jul-16 13-May-17 Mie Soa Basah
KT 1 28-Apr-16 15-Jul-16 13-May-17 Mie Soa Basah
KT 1 28-Apr-16 15-Jul-16 13-May-17 Bolu Cake
Bact 1 28-Apr-16 15-Jul-16 13-May-17 Bolu Cake
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 28-Apr-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 2-May-16 15-Jul-16 13-Agst-16 Air Minum
Bact 1 3-May-16 15-Jul-16 13-Agst-16 Air Minum
KT 1 3-May-16 15-Jul-16 13-May-17 Bubuk Kopi
Bact 1 3-May-16 15-Jul-16 13-May-17 Bubuk Kopi
KT 1 3-May-16 15-Jul-16 13-May-17 Gula Aren
Bact 1 3-May-16 15-Jul-16 13-May-17 Gula Aren
Bact 1 4-May-16 15-Jul-16 13-May-17 Mie Pansit
KT 1 4-May-16 15-Jul-16 13-May-17 Mie Pansit
Bact 1 4-May-16 15-Jul-16 13-May-17 Roti Abon
Bact 1 4-May-16 15-Jul-16 13-May-17 Coffe Coklat
KT 1 9-May-16 15-Jul-16 20-May-17 Sirup Markisah
Bact 1 9-May-16 15-Jul-16 20-May-17 Sirup Markisah
KT 1 9-May-16 15-Jul-16 20-May-17 Sirup Markisah
Bact 1 9-May-16 15-Jul-16 20-May-17 Sirup Markisah
KT 1 9-Apr-16 15-Jul-16 20-May-17 Dodol
Bact 1 9-May-16 15-Jul-16 20-May-17 Dodol
KL 1 10-May-16 15-Jul-16 10-Agst-2016 Air Bersih
Bact 1 10-May-16 15-Jul-16 20-May-17 Sayur Lodeh
Bact 1 10-May-16 15-Jul-16 20-May-17 Semur Ayam
KT 1 12-May-16 15-Jul-16 20-May-17 Pastel Ayam
Bact 1 12-May-16 15-Jul-16 20-May-17 Pastel Ayam
KT 1 12-May-16 15-Jul-16 20-May-17 Pastel Kacang
Bact 1 12-May-16 15-Jul-16 20-May-17 Pastel Kacang
Bact 1 13-May-16 15-Jul-16 20-Agst-16 Air Minum
Bact 1 13-May-16 15-Jul-16 20-Agst-16 Air Minum
Bact 1 13-May-16 15-Jul-16 20-Agst-16 Air Minum
Bact 1 13-May-16 15-Jul-16 20-Agst-16 Air Minum
Bact 1 13-May-16 15-Jul-16 20-Agst-16 Air Minum
Bact 1 13-May-16 15-Jul-16 20-Agst-16 Air Minum
Bact 1 16-May-16 15-Jul-16 23-Agst-16 Air Minum
Bact 1 16-May-16 15-Jul-16 23-Aug-16 Air Minum
Bact 1 16-May-16 15-Jul-16 23-Agst-16 Air Minum
Bact 1 17-May-16 15-Jul-16 23-May-17 Mie Tiaw
Bact 1 17-May-16 15-Jul-16 23-May-17 Kopi Halus
Bact 1 17-May-16 15-Jul-16 23-May-17 Gincu Merah Tua
Bact 1 17-May-16 15-Jul-16 23-May-17 Gincu yellow
Bact 1 17-May-16 15-Jul-16 25-May-17 Acar Kuning
Bact 1 17-May-16 15-Jul-16 25-May-17 Tauco Ikan Nila
Bact 1 17-May-16 15-Jul-16 25-May-17 Jus Jeruk
Bact 1 17-May-16 15-Jul-16 25-May-17 Ayam Balado
Bact 1 17-May-16 15-Jul-16 25-May-17 Cap Cay
Bact 1 17-May-16 15-Jul-16 25-May-17 Rendang
Bact 1 17-May-16 15-Jul-16 25-May-17 Nila Goreng
KL 1 18-May-16 15-Jul-16 25-Agst-16 Air Minum
Bact 1 24-May-16 15-Jul-16 1-Sep-16 Air Minum
KL 1 18-May-16 22-Jul-16 25-Agst-16 Air Minum
KL 1 18-May-16 22-Jul-16 25-Agst-16 Air Minum
Bact 1 18-May-16 22-Jul-16 25-May-17 Cap Cay
Bact 1 18-May-16 22-Jul-16 25-May-17 Ikan Dory
Bact 1 18-May-16 22-Jul-16 25-May-17 Daging Has Dalam
Bact 1 18-May-16 22-Jul-16 25-May-17 Jus Red Dragon
Bact 1 19-May-16 22-Jul-16 25-May-17 Roti Kacang
Bact 1 19-May-16 22-Jul-16 25-May-17 Garam
Bact 1 23-May-16 22-Jul-16 30-May-17 Kopi Halus
KT 1 16-May-16 22-Jul-16 6-Jun-17 Madu
Bact 1 16-May-16 22-Jul-16 6-Jun-17 Madu
KT 1 16-May-16 22-Jul-16 6-Jun-17 Sirup
Bact 1 16-May-16 22-Jul-16 6-Jun-17 Sirup
Bact 1 24-May-16 22-Jul-16 1-Sep-16 Air Minum
Bact 1 24-May-16 22-Jul-16 1-Sep-16 Air Minum
Bact 1 24-May-16 22-Jul-16 1-Sep-16 Air minum
Bact 1 24-May-16 22-Jul-16 1-Sep-16 Air Minum
Bact 1 24-May-16 22-Jul-16 6-Sep-16 Air Minum
Bact 1 24-May-16 22-Jul-16 31-May-17 Roti Kering
Bact 1 24-May-16 22-Jul-16 31-May-17 Roti Manis
Bact 1 24-May-16 22-Jul-16 31-May-17 Roti Tawar
Bact 1 24-May-16 22-Jul-16 31-May-17 Roti MAnis
Bact 1 24-May-16 22-Jul-16 31-May-17 Roti MAnis
Bact 1 24-May-16 22-Jul-16 31-May-17 Kue Putu
Bact 1 24-May-16 22-Jul-16 31-May-17 Kue Kering
Bact 1 24-Jul-16 30-Jul-16 31-May-16 Kerupuk Ikan
Bact 1 24-May-16 30-Jul-16 31-May-16 Kue Bangkit
Bact 1 25-May-16 30-Jul-16 6-Sep-16 Air Minum
KL 1 25-May-16 30-Jul-16 6-Sep-16 Air Minum
KL 1 25-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 25-May-16 30-Jul-16 6-May-16 Air Minum
Bact 1 25-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 25-May-16 30-Jul-16 6-May-06 Air Minum
Bact 1 24-May-16 30-Jul-16 6-Jun-17 Ikan Arsik
KT 1 24-May-16 30-Jul-16 6-Jun-17 Ikan Arsik
KT 1 24-May-16 30-Jul-16 6-Jun-17 Kerupuk Singkong
Bact 1 24-May-16 30-Jul-16 6-Jun-17 Kerupuk Singkong
Bact 1 24-May-16 30-Jul-16 6-Jun-17 Kerupuk Udang
KT 1 24-May-16 30-Jul-16 6-Jun-17 Kerupuk Udang
Bact 1 24-May-16 30-Jul-16 6-Jun-17 Tepung Goreng Ayan
KT 1 24-May-16 30-Jul-16 6-Jun-17 Tepung Goreng Ayam
Bact 1 27-May-16 30-Jul-16 6-Jun-17 Pancake Durian
KT 1 27-May-06 30-Jul-16 6-Jun-17 Pancake Durian
KL 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 26-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 27-May-16 30-Jul-16 6-Jun-17 Ubi Lapis
Bact 1 27-May-16 30-Jul-16 6-Jun-17 Timpan
Bact 1 27-May-16 30-Jul-16 6-Jun-17 Juice Alpukat
Bact 1 27-May-16 30-Jul-16 6-Jun-17 Nasi Goreng seafood
Bact 1 30-May-16 30-Jul-16 7-Sep-16 Air Minum
Bact 1 30-May-16 30-Jul-16 7-Sep-16 Air Minum
Bact 1 31-May-16 30-Jul-16 7-Jun-17 Nasi Goreng Sea food
Bact 1 31-May-16 30-Jul-16 7-Jun-17 Nasi Goreng Sea Food
Bact 1 31-May-16 30-Jul-16 7-Jun-17 Kecap Kental Manis
Bact 1 31-May-16 30-Jul-16 7-Jun-17 Kecap Encer Asin
Bact 1 31-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 31-May-16 30-Jul-16 6-Sep-16 Air Minum
Bact 1 3-Jun-16 30-Jul-16 6-Sep-06 Air Minum
Bact 1 31-May-16 30-Jul-16 6-Jun-17 Brownis
Bact 1 31-May-16 30-Jul-16 6-Jun-17 Bolu Gulung
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Rasa Kelapa
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Sri kaya
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Rasa Cream Mocca
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Rasa Kacang Hijau
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 roti rasa blu Berry
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Rasa Pandan
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 roti Rasa coklat
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Rasa Jagung
Bact 1 2-Jun-16 30-Jul-16 6-Jun-17 Roti Rasa Nanas
DAFTAR PEMERIKSAAN SAMPEL DI BALAI LABORATORIUM KESEHATAN LINGKUNGAN
BULAN : Agustus 2016

ASAL SAMPEL JENIS SAMPEL DIPERIKSA Jumlah


No. Ket
Mak/Min Limbah R.Swab Sampel
ASAL SAMPEL Alamat Air
1 Hotel Elegant Jl. Waringin No 2/16 0 1 0 0 1
2 Hotel Elegant Jl. Waringin No 2/16 0 1 0 0 1
3 Hotel Elegant Jl. Waringin No 2/16 1 0 0 0 1
4 Hotel Elegant Jl. Waringin No 2/16 1 0 0 0 1
5 Restoran Selecta Jl. Listrik 1 0 0 0 1
6 Restoran Selecta Jl. Listrik 1 0 0 0 1
7 Karaoke Stroom Jl. Listrik No 2 1 0 0 0 1
8 Pemb. Roti Rezeki Baru Jl. Perguruan 1 0 0 0 1
9 DAM Putri Water Jl. Gitar No 14 0 1 0 0 1
10 DAM Surya Water Jl. Marelan II Ling 27 0 1 0 0 1
11 DAM Kayla Water Jl. Kuta Ujung 0 1 0 0 1
12 DAM Tifa Water Jl. Bejo Pasar IV No 134/135 Laut Dendang 0 1 0 0 1
13 DAM Cinda Water Dusun XI Palu Merbau Kel. Palu Merbau Kec. Perc 0 1 0 0 1
14 DAM M.Three Water Desa Sugiharjo Kel. Batang Kuis 0 1 0 0 1
15 DAM Novita Water Jl. Pembangunan Gg Salam Lor Salam 0 1 0 0 1
16 DAM Juwita Water Jl. Pematang Jering Barak Jawa Dusun IX 0 1 0 0 1
17 DAM Jihan Water Jl. Cinta Karya Gg Mesjid 0 1 0 0 1
18 Mawar Bakery & Cake Shop Jl. Setia Budi No 2-6 Medan 1 0 0 0 1
19 Mawar Bakery & Cake Shop Jl. Setia Budi No 2-6 Medan 1 0 0 0 1
20 Mawar Bakery & Cake Shop Jl. Pinang Baris No 261 Medan 1 0 0 0 1
21 Mawar Bakery & Cake Shop Jl. Pinang Baris No 261 Medan 1 0 0 0 1
22 Mawar Bakery & Cake Shop Jl. Gatot Subroto No 347 1 0 0 0 1
23 Mawar Bakery & Cake Shop Jl. Gatot Subroto No 347 1 0 0 0 1
24 Mawar Bakery & Cake Shop Jl. B.Katamso No 809 1 0 0 0 1
25 Mawar Bakery & Cake Shop Jl. B.Katamso No 809 1 0 0 0 1
26 Mawar Bakery & Cake Shop Jl. Jamin Ginting No 115 1 0 0 0 1
27 Mawar Bakery & Cake Shop Jl. Jamin Ginting No 115 1 0 0 0 1
28 Kedai Kopi Akun Pansit Jl. Wahidin No 11 1 0 0 0 1
29 Kedai Kopi Akun Pansit Jl. S.Parman 1 0 0 0 1
30 Pemb. Mie Pansit Jl. Bilal Gg Tahir 1 0 0 0 1
31 Kedai Kopi / Mie Pansit Daikut (LK Jl. Wahidin No 11 1 0 0 0 1
32 Kedai Kopi/ Mie Ayam Tiong Sim Jl. Bogor Simpang Semarang 1 0 0 0 1
33 Pemb. Mie Pansit Jl. Gurami No 18 1 0 0 0 1
34 Pemb. Mie Pansit Jl. Rahayu 1 0 0 0 1
35 Pemb.Mie Pansit Jl. Kereta Api No 19 1 0 0 0 1
36 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
37 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
38 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
39 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
40 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
41 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
42 RSU Murni Teguh Jl. Jawa No 2 1 0 0 0 1
43 Pemb. Sirup Lemon Setia Budi Jl. Suasa No 1 (Kebun Sayur) 1 0 0 0 1
44 Pemb. Sirup Lemon Setia Budi Jl. Suasa No 1 (Kebun Sayur) 1 0 0 0 1
45 Pemb. Sirup Lemon Setia Budi Jl. Suasa No 1 (Kebun Sayur) 1 0 0 0 1
46 Pemb. Sirup Lemon Setia Budi Jl. Suasa No 1 (Kebun Sayur) 1 0 0 0 1
47 Pemb. Sirup Lemon Setia Budi Jl. Suasa No 1 (Kebun Sayur) 1 0 0 0 1
48 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
49 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
50 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
51 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
52 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
53 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
54 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
55 Super Zone Jl. Mustika No 60 C 1 0 0 0 1
56 Cap Tupai Terbang Jl. Rumah Potong Hewan No 118 A 1 0 0 0 1
57 Cap Tupai Terbang Jl. Rumah Potong Hewan No 118 A 1 0 0 0 1
58 Yo&Yu Jl. Waringjn No 46 B 1 0 0 0 1
59 Yo&Yu Jl. Waringin No 46 B 1 0 0 0 1
60 Sembilan Dua/ 92 Jl. Sabarudin No 82/30 B 1 0 0 0 1
61 Sembilan Dua/ 92 Jl. Sabarudin No 82/30 B 1 0 0 0 1
62 Snack Mie Lidi Jl. Brig Katamso gg Manggis 1 0 0 0 1
63 Snack Mie Lidi Jl. Brig Katamso gg Manggis 1 0 0 0 1
64 DAM Alpan Oxy Bio ozon Ro Jl. Durian Kp Jawa Pdang sidempuan utara 0 1 0 0 1
65 RS Mata Smec Jl. Iskandar Muda 0 1 0 0 1
66 RS Mata Smec Jl. Iskandar Muda 1 0 0 0 1
67 RS Mata Smec Jl. Iskandar Muda 1 0 0 0 1
68 RSIA Sri Ratu Jl. Nibung Raya No 204-212 0 1 0 0 1
69 RSIA Sri Ratu Jl. Nibung Raya No 204-212 1 0 0 0 1
70 Tivolli Jl. KL Yos Sudarso Lingk VII No 9 1 0 0 0 1
71 Tivolli Jl. KL Yos Sudarso Lingk VII No 9 1 0 0 0 1
72 Tivolli Jl. KL Yos Sudarso Lingk VII No 9 1 0 0 0 1
73 Fean Lock Jl. Metal Raya 1 0 0 0 1
74 Fean Lock Jl. Metal Raya 1 0 0 0 1
75 Fean Lock Jl. Metal Raya 1 0 0 0 1
76 PT.SPR Jl. Medan Belawan 1 0 0 0 1
77 DAM Mitraqua jl. Ki Hajardewantara Banjar Kubur Kec. Barumu 0 1 0 0 1
78 Pemb. Bika Ambon Ratna Jl. Mojopahit No 11D 1 0 0 0 1
79 DAM Oksi 24 Water Gunung Sitoli 0 1 0 0 1
80 Rumah Bakery Jl. Marelan Raya No 187-188 1 0 0 0 1
81 Rumah Bakery Jl. Marelan Raya No 187-188 1 0 0 0 1
82 Pemb. Snack Garuda Mas Jl. Metal I Gg insyaf 1 0 0 0 1
83 Pemb. Snack Garuda Mas Jl. Metal I Gg insyaf 1 0 0 0 1
84 Pemb. Snack Garuda Mas Jl. Metal I Gg insyaf 1 0 0 0 1
85 Pemb. Mie Jl. Marendal Psr 8 kanal gg Advokat Raya No 2 1 0 0 0 1
86 Pembuatan Mie Jl. Marendal Psr 8 kanal gg Advokat Raya No 2 1 0 0 0 1
87 pembuatan mie Jl. Marendal Psr 8 kanal gg Advokat Raya No 2 1 0 0 0 1
88 Pembuatan Bakso ikan Jl. Bakaran Batu No 19 D 1 0 0 0 1
89 Pembuatan Mie Pansit Jl. Amal no 10 A 1 0 0 0 1
90 pembuatan Roti Kering Jl. Sentosa Lama 1 0 0 0 1
91 pembuatan Bobn-bon Kelapa jl. Duyung No 137 1 0 0 0 1
92 Pembuatan Roti Bak Pou Jl. Brigjen Katamso 1 0 0 0 1
93 Pemb. Roti kering Furraya Sari Pa Jl. Asahan no 20 1 0 0 0 1
94 Pemb. Roti kering Furraya Sari Pa Jl. Asahan no 20 1 0 0 0 1
95 Pemb. Roti kering Furraya Sari Pa Jl. Asahan no 20 1 0 0 0 1
96 Pembungkusan Gincu cap Gajah Jl. Pukat VII Gg Kristen No 14/13 1 0 0 0 1
97 Pembungkusan Gincu cap Gajah Jl. Pukat VII Gg Kristen No 14/13 1 0 0 0 1
98 Pembungkusan Gincu cap Gajah Jl. Pukat VII Gg Kristen No 14/13 1 0 0 0 1
99 Pembungkusan Gincu cap Gajah Jl. Pukat VII Gg Kristen No 14/13 1 0 0 0 1
100 Pembungkusan Gincu cap Gajah Jl. Pukat VII Gg Kristen No 14/13 1 0 0 0 1
101 Pembungkusan Gincu cap Gajah Jl. Pukat VII Gg Kristen No 14/13 1 0 0 0 1
102 RSIA Rosiva jl. Bangka No 5 1 0 0 0 1
103 RSIA Rosiva jl. Bangka No 5 1 0 0 0 1
104 RSIA Rosiva jl. Bangka No 5 0 1 0 0 1
105 RSU Sarah Jl. Baja Raya No 10 0 1 0 0 1
106 RSU Sarah Jl. Baja Raya No 10 1 0 0 0 1
107 RSU sarah Jl. Baja Raya No 10 1 0 0 0 1
108 RSU Methodist Susanna Wesley Jl. Harmonika baru Pasar I pasdang Bulan 1 0 0 0 1
109 RSU Methodist Susanna Wesley Jl. Harmonika baru Pasar I pasdang Bulan 0 1 0 0 1
90 19

BALAI LABORATORIUM
KESEHATAN LINGKUNGAN MEDAN

Gemala Sari, SKM


Pembina
Nip. 19620604.198212.2.001
Jenis N Tgl. Periksa Tgl. Setor Tgl. Daluarsa Nama Sampel

KT 1 31-May-16 05-Agst-6 6-Jun-17 Air SPA Dingin


KT 1 31-May-16 05-Agst-6 6-Jun-17 Air SPA Panas
Bact 1 31-May-16 05-Agst-6 6-Jun-17 Nasi Goreng
Bact 1 31-May-16 05-Agst-6 6-Jun-17 Jus Jeruk
Bact 1 2-Jun-16 05-Agst-6 6-Jun-17 mie Goreng
Bact 1 2-Jun-16 05-Agst-6 6-Jun-17 Jus Jeruk
Bact 1 2-Jun-16 05-Agst-6 6-Jun-17 Mie Goreng
Bact 1 2-Jun-16 05-Agst-6 6-Jun-17 Roti Bohong
KL 1 9-Jun-16 05-Agst-6 15-Sep-16 Air Minum
KL 1 6-Jun-16 05-Agst-6 15-Sep-16 Air Minum
KL 1 6-Jun-16 05-Agst-6 15-Sep-16 Air Minum
KL 1 6-Jun-16 05-Agst-6 15-Sep-16 Air Minum
Bact 1 13-Jun-16 05-Agst-6 20-Sep-16 Air Minum
Bact 1 13-Jun-16 05-Agst-6 20-Sep-06 Air Minum
Bact 1 13-Jun-06 05-Agst-6 20-Sep-16 Air Minum
KL 1 13-Jun-16 05-Agst-6 20-Sep-16 Air Minum
KL 1 13-Jun-16 12-Aug-16 19-Jun-16 Air Minum
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Roti Tawar
BAct 1 9-Jun-16 12-Aug-16 15-Jun-17 Cake
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Bika Ambon
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Lapis Legit
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Caramel Pisang
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Bolu Kukus
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Brownis
Bact 1 9-Jun-16 12-Aug-16 15-Jun-17 Bolu Panggang
Bact 1 9-Jun-06 12-Aug-16 15-Jun-17 Roti Kelapa
BAct 1 9-Jun-16 12-Aug-16 15-Jun-17 Roti Coklat
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie Pansit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie Pansit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie Pansit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie PAnsit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie Pansit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie PAnsit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie Pansit
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Mie Pansit
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Roti Pisang Coklat
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Roti Sosis Keju
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Sop Bening Labu Siam + jagung
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Ayam Bumbu Kuning
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Jus Semangka
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Tumis Buncis Bawang putih
Bact 1 10-Jun-16 12-Aug-16 16-Jun-17 Ikan Bumbu Kuning
KT 1 10-Jun-16 12-Aug-16 16-Jun-17 Rasberry Syrup
KT 1 10-Jun-16 12-Aug-16 16-Jun-17 Lychee Syrup
KT 1 10-Jun-16 12-Aug-16 16-Jun-17 Sarsaparila
KT 1 10-Jun-16 12-Aug-16 16-Jun-17 Citroen Syrup
KT 1 10-Jun-16 12-Aug-16 16-Jun-17 Marquisa Syrup
KT 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa Lemon
Bact 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa Lemon
KT 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa Jeruk
Bact 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa Jeruk
KT 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa leci
Bact 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa leci
KT 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa Bunga Krisan
Bact 1 6-Jun-16 12-Aug-16 15-Jun-17 Minuman Rasa Bunga Krisan
KT 1 6-Jun-16 12-Aug-16 15-Jun-17 Mie Bulat
Bact 1 6-Jun-16 12-Aug-16 15-Jun-17 Mie Bulat
KT 1 7-Jun-16 12-Aug-16 15-Jun-17 Jelly
Bact 1 7-Jun-06 12-Aug-16 15-Jun-17 Jelly
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Minuman Kopi
Bact 1 10-Jun-16 12-Aug-16 15-Jun-17 Minuman Kopi
KT 1 10-Jun-16 12-Aug-16 15-Jun-17 Kerupuk Mie Lidi
Bact 1 10-Jun-16 12-Aug-16 15-Jun-17 Kerupuk Mie Lidi
KL 1 14-Jun-16 19-Aug-16 20-Sep-16 Air Minum
KL 1 15-Jun-16 19-Aug-16 20-Sep-16 AB.R.Operasi
Bact 1 15-Jun-16 19-Aug-16 20-Jun-17 Ayam goreng
Bact 1 15-Jun-16 19-Aug-16 20-Jun-17 Sop Kaldu Ayam
KL 1 15-Jun-16 19-Aug-16 20-Sep-16 AB.R.Operasi
Bact 1 15-Jun-16 19-Aug-16 20-Jun-17 Ayam Semur
Bact 1 14-Jun-16 19-Aug-16 20-Jun-17 Roti donat
Bact 1 14-Jun-16 19-Aug-16 20-Jun-17 Kue Sawut
Bact 1 14-Jun-16 19-Aug-16 20-Jun-17 Kue Sagu
Bact 1 14-Jun-16 19-Aug-16 20-Jun-17 Roti Tawar
Bact 1 14-Jun-16 19-Aug-16 20-Jun-17 Roti Mentega
Bact 1 14-Jun-16 19-Aug-16 20-Jun-17 Roti Kering
Bact 1 15-Jun-16 19-Aug-16 20-Jun-17 Garam Halus
KL 1 16-Jun-16 19-Aug-16 24-Sep-16 Air Minum
Bact 1 18-Jun-16 19-Aug-16 27-Jun-17 Bika Ambon
KL 1 20-Jun-16 19-Aug-16 27-Sep-16 Air Minum
Bact 1 15-Jun-16 19-Aug-16 20-Jun-17 Roti Tawar
KT 1 15-Jun-16 19-Aug-16 20-Jun-17 Roti tawar
Bact 1 21-Jun-16 19-Aug-16 27-Jun-17 Makanan Ringan Taliban
Bact 1 21-Jun-16 19-Aug-16 27-Jun-17 Mie Goreng harimie
Bact 1 21-Jun-16 19-Aug-16 27-Jun-17 Kerupuk Bawang Pedas
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Mie pansit
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Mie Kuning
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 ifu Mie (mie telor)
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Bakso Ikan
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Mie Pansit
bact 1 21-Jun-16 26-Agst-16 27-Jun-17 Roti sagon
bact 1 21-Jun-16 26-Agst-16 27-Jun-17 Bon-bon Kelapa
Bact 1 21-Jun-16 26-Agst-16 27-Jun-17 roti Bak Pou
bact 1 21-Jun-16 26-Agst-16 27-Jun-17 Roti Kacang Hijau
Bact 1 21-Jun-16 26-Agst-16 27-Jun-17 roti Ketsuri
Bact 1 21-Jun-16 26-Agst-16 27-Jun-17 Roti Kering Mentega
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Gincu green
KT 1 21-Jun-16 26-Agst-16 27-Jun-07 Gincu rose Pink
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Gincu Red
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Gincu Yellow
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Gincu chocolat
KT 1 21-Jun-16 26-Agst-16 27-Jun-17 Gincu orange
Bact 1 14-Jun-16 26-Agst-16 27-Jun-17 Semur Ayam
Bact 1 14-Jun-16 26-Agst-16 27-Jun-17 Sop Ayam
KL 1 14-Jun-16 26-Agst-16 27-Sep-17 AB. R.Operasi
KL 1 20-Jun-16 26-Agst-16 27-Jun-17 AB.r.Operasi
Bact 1 20-Jun-16 26-Agst-16 27-Jun-17 Jagung Wotel rebus
Bact 1 20-Jun-16 26-Agst-16 27-Jun-17 Ikan Bawal panggang
Bact 1 22-Jun-16 26-Agst-16 27-Jun-17 Tumis Ikan Gembung
KL: 1 22-Jun-16 26-Agst-16 27-Jun-17 Ab. R. Operasi
DAFTAR PEMERIKSAAN SAMPEL DI BALAI LABORATORIUM KESEHATAN LINGKUNGAN
BULAN : September 2016

ASAL SAMPEL JENIS SAMPEL DIPERIKSA Jumlah


No. Ket
Sampel
ASAL SAMPEL Alamat Mak/Min Air Limbah R.Swab
1 ATKP Medan Jl. Penerbangan No 85 Medan 0 1 0 0 1
2 ATKP Medan Jl. Penerbangan No 85 Medan 0 1 0 0 1
3 TKP Medan Jl. Penerbangan No 85 Medan 0 1 0 0 1
4 Restoran Texas Chickhen Texas Thamrin Plazza 1 0 0 0 1
5 Restoran Texas Chickhen Texas Aksara 1 0 0 0 1
6 Restoran Texas Chickhen Texas Medan Mall 1 0 0 0 1
7 Restoran Texas Chickhen Texas Plaza Medan fair 1 0 0 0 1
8 Restoran Texas Chickhen Texas Merak Jingga 1 0 0 0 1
9 Restoran Texas Chickhen Texas Epicentrum 1 0 0 0 1
10 Restoran Texas Chickhen Texas SM Raja 1 0 0 0 1
11 Restoran Texas Chickhen Texas Suzuya Marelan 1 0 0 0 1
12 Restoran Texas Chickhen Texas Yuki Sp Raya 1 0 0 0 1
13 Restoran Texas Chickhen Texas City Check in 1 0 0 0 1
14 Kantin SD St Thomas 2 Jl. Gatot Subroto Gg Harapan No 6 1 0 0 0 1
15 Kantin SD St Thomas 2 Jl. Gatot Subroto Gg Harapan No 6 1 0 0 0 1
16 Rumah Makan Garuda Jl. Gajah Mada no 8 1 0 0 0 1
17 Rumah Makan Garuda jl. AR Hakim No 31 1 0 0 0 1
18 Rumah Makan Garuda Jl.Adam Malik No 14 1 0 0 0 1
19 Rumah Makan Garuda Jl. Palang Merah No 26-26 A 1 0 0 0 1
20 Rumah Makan Garuda Jl. Patimura No 238 1 0 0 0 1
21 Rumah Makan Garuda Jl. Nibung Raya No 165 1 0 0 0 1
22 Yammie Jl. Mojopahit No 12 C 1 0 0 0 1
23 Yammie Jl. Mojopahit No 12 C 1 0 0 0 1
24 RSU Royal Prima Jl. Ayahanda No 68 A 1 0 0 0 1
25 RSU Royal Prima Jl. Ayahanda No 68 A 1 0 0 0 1
26 RSU Royal Prima Jl. Ayahanda No 68 A 1 0 0 0 1
27 RSU Royal Prima Jl. Ayahanda No 68 A 1 0 0 0 1
28 RSU Royal Prima Jl. Ayahanda No 68 A 0 1 0 0 1
29 RSU Royal Prima Jl. Ayahanda No 68 A 0 1 0 0 1
30 Koki Sunda jl. Hasanudin No 1 1 0 0 0 1
31 Koki Sunda Jl.Hasanudin No 1 1 0 0 0 1
32 Koki Sunda jl. Hasanudin No 1 1 0 0 0 1
33 DAM frest Water Jl. Makmur Dusun V Tembung Percut sei 0 1 0 0 1
34 DAM Rido Water Jl. Limau Manis No 52 Tj.morawa Kel. L 0 1 0 0 1
35 DAM Lubis Water Perumahan cendana Asri Blok A Desa Sen 0 1 0 0 1
36 DAM Ramadhan Water Jl. Makmur Dusun V Dahlia Tembung Perc 0 1 0 0 1
37 DAM Baharata Water Jl. Makmur VII Tembung Percut sei Tuan 0 1 0 0 1
38 DAM Auzan Water Jl. Makmur Pasar VII Tembung Percut Sei 0 1 0 0 1
39 DAM Dikitakiti Water Jl. Perumahan Cendana Asri Blok E Desa 0 1 0 0 1
40 DAM AMS RO Jl. Karya Ujung Lk II No 279 Kel. Karan 0 1 0 0 1
41 DAM Gemini Water jl. BJ.Hamid Kel.Titi Kuning Kec. Medan 0 1 0 0 1
42 DAM Prima Water RO Jl. STM Suka Cerdas No 18 Titi Kuning 0 1 0 0 1
43 DAM Vynslynn RO Jl. BJ. Hamid No 10 AB Kel Kedai Durian 0 1 0 0 1
44 DAM Green Jl. Berlian Sari n/G Baru No 73 Kedai dur 0 1 0 0 1
45 DAM Ariesta Oxy Ro Jl. Kamboja 458 Helvetia 0 1 0 0 1
46 DAM Joy Oxy Water Jl. Pendidikan No 97 A Kp Lalang 0 1 0 0 1
47 Aneka Jl. Dagan no 3/8 1 0 0 0 1
48 Aneka Jl. Dagan no 3/8 1 0 0 0 1
49 Nonya Jl. Harimau No 131 C 1 0 0 0 1
50 Nonya Jl. Harimau No 131 C 1 0 0 0 1
51 Sunboi dan Bit Marquisa Jl. Besi No 3/27/L 1 0 0 0 1
52 DAM Angga Water Jl. Komp TKBM Pematang Johar, kel pema 0 1 0 0 1
53 DAM Salju Amalin Water Dusun IV Paya Kangkung Desa Kepala Sun 0 1 0 0 1
54 PT Sumaco Jl. Batang Kuis No 5 1 0 0 0 1
55 PT Sumaco Jl. Batang Kuis No 5 1 0 0 0 1
56 Mama Jutek Jl. MT Haryono No 29/17 1 0 0 0 1
57 Mama Jutek Jl. MT Haryono No 29/17 1 0 0 0 1
58 Bread History Jl. Metal Raya No 43 Medan 1 0 0 0 1
59 Bread History Jl. Metal Raya No 43 Medan 1 0 0 0 1
60 Jean Lock Jl. Metal Lk XI No 61 1 0 0 0 1
61 Jean Lock Jl. Metal Lk XI No 61 1 0 0 0 1
62 Mbak Watie Jl. Bajak Dalam No 20 E 1 0 0 0 1
63 Mbak Watie Jl. Bajak Dalam No 20 E 1 0 0 0 1
64 Graha Bakery Jl. Kapt Muslim No 23 2 C helvetia 1 0 0 0 1
65 Graha Bakery Jl. Kapt Muslim No 23 2 C helvetia 1 0 0 0 1
66 PT. Putri Eka Maju Jl. Pulau Palu No 1 KIM I Medan Deli 1 0 0 0 1
67 Restoran Jimbaran Jl. Babura Baru No 47 1 0 0 0 1
68 Restoran Jimbaran Jl. Babura Baru No 47 1 0 0 0 1
69 The Coffee Crowd Plaza Medan Fair 1 0 0 0 1
70 The Coffee Crowd Sun Plaza 1 0 0 0 1
71 The Coffee Crowd Center Point 1 0 0 0 1
72 The Coffee Crowd Cambridge City Square 1 0 0 0 1
73 KFC Jl. Gajah Mada 1 0 0 0 1
74 KFC Jl. Gajah Mada 1 0 0 0 1
75 RSIA Stella Maris Jl. Samanhudi No 20 1 0 0 0 1
76 RSIA Stella Maris Jl. Samanhudi No 20 1 0 0 0 1
77 RSIA Stella Maris Jl. Samanhudi No 20 0 1 0 0 1
78 RSIA Stella Maris Jl. Samanhudi No 20 0 1 0 0 1
79 Bravo Jl. Batang Kuis No 5 Medan 1 0 0 0 1
80 Bravo Jl. Batang Kuis No. 5 Medan 1 0 0 0 1
81 Jegar Jl. Jember No.5 Medan 1 0 0 0 1
82 Jegar Jl. Jember No.5 Medan 1 0 0 0 1
83 Eli Water Jl. Dusun I Desa Tengah Kec. Pantai Labu 0 1 0 0 1
84 Rizki Water Jl. Desa Regemuk Kec. Pantai Labu 0 1 0 0 1
85 Laisa Water Jl. Pasar 7 Bengkel Tembung 0 1 0 0 1
86 Amel Water Jl. Dusun I Sugiharjo 0 1 0 0 1
87 Ayu 2 N Jl. Klambir 5 Pasar I Umum 0 1 0 0 1
88 Nazwa Water Jl. Panah Hijau Lingkungan 7 0 1 0 0 1
89 Jernih Water Jl. Horas No.20 0 1 0 0 1
90 Sejuk Water RO Jl. Horas No 66 D 0 1 0 0 1
91 Pass Qua Water Jl. Pasar 3 Komp. Graha Krakatau B 8 Me 0 1 0 0 1
92 Banyu Water Jl Pukat Vi no 26 B 0 1 0 0 1
93 Ibsupsi Water Jl. Pimpinan No 145 Kel. Sei Kera hilir I 0 1 0 0 1
94 Aqua Fina Water Jl. Madong Lubis No 26 H Medan Perjuan 0 1 0 0 1
95 Roby Water Jl. Karya No 223 Karang Berombak Kec. 0 1 0 0 1
96 Mulia Water Jl. RPH No 10 Kec. Medan Deli 0 1 0 0 1
97 Star Water Des Jl. RPH No 34 Mabar 0 1 0 0 1
98 Lasima Water Jl. Mangaan VI No 23 Medan deli 0 1 0 0 1
99 Satria Water Jl. Mangaan VII LK XVII Kel. Mabar Kec 0 1 0 0 1
100 Muutiara Water Jl. Mangaan No 211 Kel. Mabar Kec. Med 0 1 0 0 1
101 Mustaqiim Water Jl. Eka Rasmi Kel. Gedung Johor Kec. Me 0 1 0 0 1
102 Papa roti Jl. Karantina I No 9 Glugur Darat II 1 0 0 0 1
103 Papa Roti Jl. Karantina I No 9 Glugur Darat II 1 0 0 0 1
104 Soya Pannacota Jl. Sabaruddin No VI A 1 0 0 0 1
105 Sonya Pannacota Jl. Sabaruddin No VI A 1 0 0 0 1
106 Pancake Durian Mei Cin Jl. Ketapang No 11 1 0 0 0 1
107 Pancake Durian Mei Cin Jl. Ketapang No 11 1 0 0 0 1
108 CV Rafha Jl. Yos Sudarso LK II No 48 1 0 0 0 1
109 CV. Rafha Jl. Yos Sudarso LK II No 48 1 0 0 0 1
110 Suan's Bakery Jl. Taruma No 9B 1 0 0 0 1
111 Suan's Bakery Jl. Taruma No 9B 1 0 0 0 1
112 Suan's Bakery Jl. Taruma No 9B 1 0 0 0 1
113 CV. Zam Zami Alget Jl. Lintas Timur No 16 Kel. Panyabungan 0 1 0 0 1
114 Najma Water Jl. Kongsi Gg Sejahtera Marindal 0 1 0 0 1
70 44
Jenis N Tgl. Periksa Tgl. Setor Tgl. Daluarsa Nama Sampel

KL 1 21-Jun-16 9-Sep-16 27-Sep-16 Air Minum Sarama D


KL 1 21-Jun-16 9-Sep-16 27-Sep-16 Air Minum R.Makan
KL 1 21-Jun-16 9-Sep-16 27-Sep-16 Air MinumAsrama C
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 21-Jun-16 9-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Mie Tiaw Goreng
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Pisang Goreng
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Rendang
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Rendang
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Rendang
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Rendang
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Rendang
Bact 1 22-Jun-16 9-Sep-16 30-Jun-17 Rendang
Bact 1 23-Jun-16 9-Sep-16 30-Jun-17 Brownies Kukus
Bact 1 23-Jun-16 9-Sep-16 30-Jun-17 Brownies Panggang
Bact 1 23-Jun-16 9-Sep-16 30-Jun-17 Sop oyong
Bact 1 23-Jun-16 9-Sep-16 30-Jun-17 Saos Asam Manis
Bact 1 23-Jun-16 9-Sep-16 30-Jun-17 Jus Semangka
Bact 1 23-Jun-16 9-Sep-16 30-Jun-17 Ayam goreng tepung
KL 1 23-Jun-16 16-Sep-16 30-Sep-16 AB.R.Operasi
KL 1 23-Jun-16 16-Sep-16 30-Sep-16 Air Minum Pantry Lt.15
Bact 1 23-Jun-16 16-Sep-16 30-Jun-17 Juice jeruk
Bact 1 23-Jun-16 16-Sep-16 30-Jun-17 Gurami goreng
Bact 1 23-Jun-16 16-Sep-16 30-Jun-17 Ayam Goreng
Bact 1 22-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 22-Jun-16 16-Sep-16 30-Sep-16 Air Minum
bact 1 22-Jun-16 16-Sep-16 30-Jun-16 Air minum
Bact 1 22-Jun-16 16-Sep-16 30-Oct-16 Air minum
Bact 1 22-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 22-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 22-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 22-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 23-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 23-Jun-16 16-Sep-16 30-Sep-16 air Minum
Bact 1 23-Jun-16 16-Sep-16 30-Sep-16 Air minum
Bact 1 23-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 23-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 23-Jun-16 16-Sep-16 30-Sep-16 Air Minum
Bact 1 23-Jun--16 16-Sep-16 30-Jun-17 Bika Ambon
KT 1 23-Jun-16 16-Sep-16 30-Jun-17 Bika AMbon
Bact 1 23-Jun-16 16-Sep-16 30-Jun-17 Bika Ambon
KT 1 23-Jun-16 16-Sep-16 30-Jun-17 Bika Ambon
Bact 1 28-Jun-16 16-Sep-16 18-Jul-17 Juice Sunboi
Bact 1 27-Jun-16 16-Sep-16 18-Oct-16 Air Minum
KL 1 28-Jun-16 16-Sep-16 18-Oct-16 Air Minum
KT 1 29-Jun-16 16-Sep-16 18-Jul-17 Minuman The
Bact 1 29-Jun-16 16-Sep-16 18-Jul-17 Minuman The
KT 1 29-Jun-16 16-Sep-16 18-Jul-17 Sambal Andaliman
Bact 1 29-Jun-16 16-Sep-16 18-Jul-17 Sambal Andaliman
KT 1 29-Jun-16 16-Sep-16 18-Jul-17 Roti Tawar
Bact 1 29-Jun-16 16-Sep-16 18-Jul-17 Roti Tawar
KT 1 29-Jun-16 16-Sep-16 18-Jul-17 Kue Kering
Bact 1 29-Jun-16 16-Sep-16 18-Jul-17 Kue Kering
KT 1 30-Jun-16 16-Sep-16 18-Jul-17 Bumbu Rujak
Bact 1 30-Jun-16 16-Sep-16 18-Jul-17 Bumbu Rujak
KT 1 30-Jun-16 16-Sep-16 18-Jul-17 Bolu
Bact 1 30-Jun-16 16-Sep-16 18-Jul-17 Bolu
KT 1 11-Jul-16 23-Sep-16 18-Jul-17 Es Batangan
Bact 1 12-Jul-16 23-Sep-16 26-Jul-17 Juice Jeruk
Bact 1 12-Jul-16 23-Sep-16 26-Jul-17 Cah Kangkung
Bact 1 15-Jul-16 23-Sep-16 26-Jul-17 Nasi Goreng
Bact 1 15-Jul-16 23-Sep-16 26-Jul-17 Mie Goreng
Bact 1 15-Jul-16 23-Sep-16 26-Jul-17 The Manis Dingin
Bact 1 15-Jul-16 23-Sep-16 26-Jul-17 Juice Jeruk
Bact 1 15-Jul-16 23-Sep-16 26-Jul-17 Ayam Goreng original
Bact 1 15-Jul-16 23-Sep-16 26-Jul-17 Ayam Goreng Crispy
Bact 1 19-Jul-16 23-Sep-16 Cap Caui Gabus Pekko
Bact 1 19-Jul-16 23-Sep-16 Stim Ayam
KL 1 19-Jul-16 23-Sep-16 AB.R.Operasi
KL 1 19-Jul-16 23-Sep-16 AB.R. Baby Spa
KT 1 13-Jul-16 23-Sep-16 26-Jul-17 Sirup Hazelnut
Bact 1 13-Jul-16 23-Sep-16 26-Jul-17 sirup Hazelnut
KT 1 14-Jul-16 23-Sep-16 26-Jul-17 Minuman Jelly
Bact 1 14-Jul-16 23-Sep-16 26-Jul-17 Minuman Jelly
Bact 1 15-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 15-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 15-Jul-16 23-Sep-16 2-Nov-16 Air Minum
KL 1 14-Jul-16 23-Sep-16 29-Oct-16 Air Minum
KL 1 18-Jul-16 23-Sep-16 29-Oct-16 Air Minum
KL 1 18-Jul-16 23-Sep-16 29_Okt-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
KL 1 20-Jul-16 23-Sep-16 29-Oct-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21--Juli-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Aiir Minum,
Bact 1 21-Jul-16 23-Sep-16 2-Nov-16 Air Minum
Bact 1 22-Jul-16 23-Sep-16 2-Nov-16 Air Minum
KT 1 27-Jul-16 23-Sep-16 4-Aug-17 Selai Sri kaya
Bact 1 27-Jul-16 23-Sep-16 4-Aug-17 Selai Sri Kaya
Bact 1 21-Jul-16 23-Sep-16 08-Agut-17 Minuman Sari Kedele
KT 1 21-Jul-16 23-Sep-16 8-Aug-17 Minuman Sari Kedele
Bact 1 21-Jul-116 23-Sep-16 8-Aug-17 Pancake Durian
KT 1 21-Jul-16 23-Sep-16 8-Aug-17 Pancake Durian
Bact 1 21-Jul-16 23-Sep-16 8-Aug-17 Ikan Sambal
Bact 1 21-Jul-16 23-Sep-16 8-Aug-17 Sayur Sop
Bact 1 22-Jul-16 23-Sep-16 8-Aug-17 Roti Tawar Queen Toast
BAct 1 22-Jul-16 23-Sep-16 8-Aug-17 Roti Coklat
Bact 1 22-Jul-16 23-Sep-16 8-Aug-17 Roti Polo Butter
KL 1 25-Jul-16 23-Sep-16 8-Nov-16 Air Minum
KL 1 25-Jul-16 23-Sep-16 8-Nov-16 Air Minum