No.: Ser.13.

141511AK3IUN112015

KEMENTERIAN KETENAGAKERJAAN R.I.

MINISTRY OF MANPOWER OF THE REPUBLIC OF INDONESIA

DIREKTORAT JENDERAL PEMBINAAN PENGAWASAN KETENAGAKERJAAN DAN

KESELAMATAN DAN KESEHATAN KERJA
DIRECTORA TE GENERAL OF LABOUR INSPECTION DEVELOPMENT AND OCCUPA TlONAL SAFETY AND HEAL TH

C?mt!JiMltl
diberikan kepada :
awardedto:

Nama Siswo Tri Harmoko, S.Si

Name

Tempat, tanggallahir Jakarta, 18 Februari 1976

Place and date of birlh

Perusahaan
Company
PT. Lycon Asia Mandiri
Alamat : JI. Jemursari Utara II No. 30 Surabaya
Address

TELAH MENGIKUTI
has successfully followed

PEMBINAAN PENGAWASAN NORMA KESELAMATAN DAN KESEHATAN KERJA

The Supervision Development of Occupational Safety and Heaffh Norms .

diselenggarakan oleh
conducted by

PT. Abdi Karya Anugrah

di Sekolah Tingai I1mu Ekonomi Indonesia, Surabaya
In ~kolah Tinggi IImu Ekonomi Indonesia, Surabaya

pada tanggal 18 sjd 30 Mei 2015

on May 18 unbl30, 2015

Pemegang Sertifikat ini memenuhi persvaratan sebagai

The holder of this certificate has fulfilled the requirements as

Ahli Keselamatan dan Kesehatan Kerja

Occupational Safety and Health Expert

sesuai Peraturan Menteri Tenaga Kerja R.I. Nomor Per. 02jMenj1992 tentang Tata Cara
Penunjukan, Kewajiban dan Wewenang Ahli Keselamatan dan Kesehatan Kerja.
according to the Regulalion of the Mintster of Manpower of the Republic of Indonesia Number: Per.02lMenl1992 concerning the Procedures of Appointment, ObligatIons
and Authority of Occupational Safety and Heaffh Experts.

Jakarta, 19 Juni 2015

Jakarla, June 19, 2015

A.n. Menteri Ketenagakerjaan R.I

On behalf of the Minister of Manpower of the Republic of Indonesia