CEK LIST KE

BULAN :
RUANGAN :
HASIL KEGIATAN JENIS KEGIATAN

TGL PETUGAS BERSIH/TIDAK

PARAF
BERSIH
SANITARIAN
MENGEPELMENYIKAT
MEMBERSIHKAN
LANGIT-LANGIT
TOILET
KACA PINTU/JENDELA
1 B/TB
2 B/TB
3 B/TB
4 B/TB
5 B/TB
6 B/TB
7 B/TB
8 B/TB
9 B/TB
10 B/TB
11 B/TB
12 B/TB
13 B/TB
14 B/TB
15 B/TB
16 B/TB
17 B/TB
18 B/TB
19 B/TB
20 B/TB
21 B/TB
22 B/TB
23 B/TB
24 B/TB
25 B/TB
26 B/TB
27 B/TB
28 B/TB
29 B/TB
30 B/TB
31 B/TB
 CEK LIST KEBERSIHAN TOILET

NIS KEGIATAN KOMPONEN YANG HARUS DILENGKAPI

DINDING BAK GAYUNG

MENCUCI TEMPAT
PLASTIK
SAMPAH
SABUN
SAMPAHCUCI TANGAN
AIR
PENGHARUM
MENGUMPULKAN
RUANGAN
SAMPAHPARAF
NON MEDIS

Samarinda,….........................................
PETUGAS
 KET CATATAN

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