Anda di halaman 1dari 1

BERITA ACARA

Pada hari ini ………. tanggal ………. bulan ………. tahun DUA RIBU SEMBILAN BELAS
telah dilakukan Monitoring / Kunjungan lapangan sebagai bagian dari program pengawasan
dan Pembinaan kepada :

Nama Perusahaan : ..................................................................................................


Bidang Usaha : ..................................................................................................
Alamat : ..................................................................................................
Kabupaten : ..................................................................................................

Dengan hasil sebagai berikut :

................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................

Demikian Berita Acara ini dibuat, untuk digunakan sebagaimana mestinya

, ……….………. 2019

PT Pertamina (Persero). PT……..…..……………….

(…………………………….) (…………………………….)

Anda mungkin juga menyukai